Transluminal balloon angioplasty, each additional peripheral artery other than renal or other visceral artery, iliac or lower extremity, radiological supervision and interpretation (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Transluminal Balloon Angioplasty of Peripheral Arteries
Summary
Transluminal balloon angioplasty is a minimally invasive procedure used to open up clogged or narrowed arteries outside of the heart and brain. In this extension, the procedure focuses on additional peripheral arteries in the iliac or lower extremities, following an initial angioplasty.
Purpose
This procedure addresses peripheral artery disease (PAD), where arteries in the legs or lower body become narrowed or blocked, reducing blood flow. The goal is to restore proper blood circulation to alleviate pain, improve mobility, and prevent more serious complications like tissue damage or gangrene.
Indications
- Symptoms like leg pain, cramps, or heaviness during exercise (claudication).
- Resting leg pain indicating severe PAD.
- Non-healing wounds or ulcers on legs or feet.
- Reduced blood flow identified via imaging tests.
Preparation
- Fasting for several hours (usually 6-8) before the procedure.
- Adjusting medications as directed, particularly blood thinners.
- Pre-procedure diagnostic tests, such as ultrasounds, CT angiography, or MRI to assess the arteries.
Procedure Description
- Anesthesia: Local anesthesia with possible mild sedation.
- Access: A small incision is made, typically in the groin area.
- Guidewire: A guidewire is threaded through the incision to the target artery.
- Balloon: A catheter with a deflated balloon is guided over the wire to the narrowed section.
- Inflation: The balloon is inflated to widen the artery, compressing the plaque against the artery wall.
- Stents: If needed, stents (tiny tubes) may be placed to keep the artery open.
- Completion: The balloon is deflated and removed, and the incision is closed.
Duration
The procedure typically takes 1-2 hours, depending on the complexity.
Setting
Performed in a hospital's interventional radiology suite or a specialized outpatient clinic.
Personnel
- Interventional Radiologist or Vascular Surgeon
- Radiologic Technologist
- Nursing Staff
- Anesthesiologist or Nurse Anesthetist
Risks and Complications
- Bleeding or hematoma at the incision site
- Artery damage or rupture
- Blood clots or embolism
- Infection
- Rarely, kidney complications from contrast dye
Benefits
- Improved blood flow in the treated arteries.
- Relief from symptoms like pain and cramping.
- Enhanced mobility and quality of life.
- Reduced risk of severe complications like tissue damage.
Recovery
- Monitoring in a recovery area for a few hours post-procedure.
- Instructions on care for the incision site.
- Avoiding strenuous activities for a few days.
- Follow-up appointments to monitor the artery's health.
Alternatives
- Medication management for PAD
- Lifestyle changes: Diet, exercise, quitting smoking
- Bypass surgery for severe cases
- Other minimally invasive procedures like atherectomy
Patient Experience
During the procedure, patients might feel pressure but should not feel pain due to anesthesia. Post-procedure discomfort is usually minimal and managed with pain medications. Most patients can resume normal activities within a few days but should follow specific recovery instructions provided by their healthcare team.