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Ultrasound guidance for, and monitoring of, parenchymal tissue ablation

CPT4 code

Name of the Procedure:

Ultrasound Guidance for, and Monitoring of, Parenchymal Tissue Ablation Common name(s): Ultrasound-guided tissue ablation, US-guided ablation

Summary

Ultrasound-guided tissue ablation is a minimally invasive procedure used to destroy abnormal tissue within solid organs, such as the liver, kidneys, or lungs. By using ultrasound imaging, doctors can accurately target and monitor the area being treated, ensuring precision and enhancing patient safety.

Purpose

The primary purpose of this procedure is to treat conditions such as tumors or abnormal tissue growths within parenchymal (solid) organs. The goals are to eliminate the abnormal tissue, reduce symptoms, and improve organ function.

Indications

  • Presence of liver, kidney, or lung tumors
  • Benign or malignant lesions within parenchymal organs
  • Patients who are not candidates for surgery
  • Persistent symptoms not alleviated by other treatments

Preparation

  • Patients may be required to fast for 6-8 hours before the procedure.
  • Adjustments to certain medications, such as blood thinners, may be necessary.
  • Pre-procedure imaging studies (e.g., CT scan or MRI) to assess the lesion and plan the ablation.
  • Blood tests to evaluate liver and kidney function.

Procedure Description

  1. The patient lies on an examination table.
  2. Local anesthesia is applied to numb the area, and in some cases, sedation or general anesthesia may be used.
  3. An ultrasound probe is used to locate the target tissue.
  4. A thin needle or probe is then inserted through the skin and guided to the abnormal tissue using real-time ultrasound imaging.
  5. Energy (e.g., radiofrequency, microwave, or laser) is delivered through the probe to heat and destroy the abnormal tissue.
  6. The area is continually monitored via ultrasound to ensure complete ablation.
  7. Once the procedure is complete, the probe is removed, and a bandage is applied to the puncture site.

Duration

The procedure typically takes 1-3 hours, depending on the size and location of the tissue being treated.

Setting

Ultrasound-guided tissue ablation is usually performed in a hospital, radiology department, or outpatient surgical center.

Personnel

  • Interventional Radiologist or Surgeon
  • Ultrasound Technician
  • Nurse
  • Anesthesiologist (if sedation or general anesthesia is used)

Risks and Complications

  • Infection at the incision site
  • Bleeding or bruising
  • Damage to surrounding tissues or organs
  • Pain or discomfort at the treatment site
  • Rarely, a need for additional treatments if the initial ablation is incomplete

Benefits

  • Minimally invasive with a shorter recovery time compared to open surgery
  • Precise targeting of abnormal tissue, reducing damage to healthy tissue
  • Relief of symptoms and improved organ function
  • Potential for repeat treatments if necessary

Recovery

  • Patients may need to rest for a few hours before being discharged.
  • Mild pain or discomfort at the treatment site is common and can be managed with pain relievers.
  • Most patients can resume normal activities within a few days.
  • Follow-up appointments and imaging studies will be scheduled to monitor recovery and ensure the effectiveness of the ablation.

Alternatives

  • Surgical removal of the abnormal tissue, which may involve longer recovery times and higher risks.
  • Radiation therapy, which can be effective but may have more side effects.
  • Chemotherapy, particularly for malignant tumors, though it may be less targeted and cause systemic side effects.

Patient Experience

During the procedure, patients may feel pressure or mild discomfort when the probe is inserted. Post-procedure, some soreness or minor pain at the puncture site is common, but this is typically manageable with over-the-counter pain medication. Overall, ultrasound-guided tissue ablation is well-tolerated, and most patients recover quickly with minimal discomfort.

Medical Policies and Guidelines for Ultrasound guidance for, and monitoring of, parenchymal tissue ablation

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