Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, ven
CPT4 code
Name of the Procedure:
Catheter placement in coronary arteries and bypass grafts for coronary angiography (with intraprocedural injection, imaging supervision, and interpretation)
Summary
Catheter placement in coronary arteries and bypass grafts is performed to visualize the heart's blood vessels. Using a catheter, a thin, flexible tube, a contrast dye is injected into the coronary arteries and bypass grafts. This procedure helps physicians capture detailed images and diagnose heart conditions.
Purpose
The procedure provides clear images of the coronary arteries and bypass grafts, identifying blockages or abnormalities that could result in heart disease or complications. The goal is accurate diagnosis to guide treatment decisions and improve patient outcomes.
Indications
- Chest pain (angina)
- Suspected or confirmed coronary artery disease (CAD)
- Irregular stress test results
- Post-coronary artery bypass grafting (CABG) assessment
Preparation
- Fasting for at least 6-8 hours before the procedure
- Adjusting or temporarily stopping certain medications (e.g., blood thinners)
- Pre-procedure tests, including blood work, ECG, and possibly a chest X-ray
Procedure Description
- Anesthesia: Local anesthesia is administered to numb the insertion site, usually in the groin or wrist.
- Catheter Insertion: A small incision is made, and a catheter is guided through the blood vessels to the coronary arteries and bypass grafts.
- Contrast Injection: A contrast dye is injected through the catheter.
- Imaging: X-ray or fluoroscopy captures real-time images of the blood flow in coronary arteries and bypass grafts.
- Interpretation: A cardiologist interprets the images to assess any blockages or abnormalities.
Duration
The procedure typically lasts 30 minutes to 1 hour.
Setting
Performed in a hospital's catheterization lab (cath lab).
Personnel
- Interventional cardiologist
- Nursing staff
- Radiologic technologist
- Possible presence of an anesthesiologist
Risks and Complications
- Minor: Bruising or bleeding at the insertion site, allergic reaction to contrast dye
- Major (rare): Heart attack, stroke, arrhythmias, kidney damage
Benefits
- Accurate diagnosis of cardiovascular issues
- Guides treatment plans, including potential interventions like angioplasty or bypass surgery
Recovery
- Monitoring in the recovery area for several hours
- Instructions to avoid strenuous activity for a few days
- Follow-up appointments to discuss results and next steps
Alternatives
- Non-invasive tests like CT angiography or stress tests
- Pros: Less invasive, quicker recovery
- Cons: Less detailed, might not provide sufficient information for definitive diagnosis
Patient Experience
- Light pressure or minimal discomfort during catheter insertion
- Sensation of warmth when contrast dye is injected
- Post-procedure soreness at the insertion site
- Pain management with over-the-counter pain relievers if necessary