Chemotherapy administration, intra-arterial; push technique
CPT4 code
Name of the Procedure:
Chemotherapy Administration, Intra-Arterial; Push Technique
Summary
This procedure involves delivering chemotherapy directly into an artery using a push technique. This method ensures a high concentration of the cancer-fighting drug reaches the targeted area, potentially increasing its effectiveness.
Purpose
The intra-arterial chemotherapy push technique is used to treat cancers localized to specific regions. By delivering the chemotherapy directly to the affected area, it aims to maximize the drug's cancer-fighting properties while minimizing systemic side effects.
Indications
This procedure is indicated for patients with localized tumors, such as liver or brain cancers. It's appropriate when traditional systemic chemotherapy is insufficient or too risky for the patient. Candidates are evaluated based on factors like tumor location, size, and overall health.
Preparation
Patients may need to fast for a few hours before the procedure. Medications may need to be adjusted. Pre-procedure assessments include blood tests and imaging studies like CT scans or MRIs to map the arteries and tumor.
Procedure Description
- The patient is positioned comfortably, and local anesthesia is applied to numb the insertion area.
- A catheter is inserted into a major artery, usually through the groin or arm.
- Using imaging guidance (fluoroscopy), the catheter is navigated to the artery supplying blood to the tumor.
- The chemotherapy drug is administered swiftly through the catheter directly into the artery.
- The catheter is then removed, and pressure is applied to the insertion site to prevent bleeding.
The procedure involves specialized equipment such as catheters, fluoroscopy machines, and chemotherapy infusion systems.
Duration
The procedure typically takes 1 to 2 hours, depending on the complexity and the location of the tumor.
Setting
The procedure is usually performed in a hospital's interventional radiology or oncology department.
Personnel
The team includes an interventional radiologist, oncology nurse, and a radiology technician. An anesthesiologist may be present if deeper sedation is required.
Risks and Complications
Common risks include infection at the insertion site, blood clots, and artery damage. Rarely, the procedure can cause kidney damage or severe allergic reactions to the chemotherapy drug. Close monitoring helps manage these potential complications.
Benefits
The primary benefit is targeted treatment of the tumor with minimal systemic exposure, potentially reducing overall side effects. Patients may notice improvements in cancer symptoms within weeks to months.
Recovery
After the procedure, patients are monitored in a recovery area for a few hours. They may need to rest for a day or two and limit strenuous activities. Follow-up appointments are essential to monitor treatment progress and manage side effects.
Alternatives
Other treatment options include systemic chemotherapy, surgical resection, and radiation therapy. Each alternative has its own set of pros and cons, such as varying degrees of invasiveness, effectiveness, and side effect profiles.
Patient Experience
Patients may feel pressure or mild discomfort during the catheter insertion. Post-procedure, it's common to experience fatigue and local tenderness. Pain management includes prescribed pain medications and comfort measures like ice packs and rest.