Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access
HCPCS code
Name of the Procedure:
Implantable Access Catheter (e.g., Venous, Arterial, Epidural Subarachnoid, or Peritoneal)
Summary
An implantable access catheter is a medical device inserted into your body to provide a pathway for delivering medications, fluids, or for withdrawing blood. It can be placed in a venous, arterial, epidural subarachnoid, or peritoneal location, depending on the medical requirement. The external access type (A4300) means a portion of the catheter remains outside the body for easy access.
Purpose
The implantable access catheter addresses medical conditions requiring frequent or long-term intravenous (IV) therapy, medication delivery, blood drawing, or fluid removal. The goal is to provide a reliable and safe access to the body's circulatory system or specific area requiring treatment.
Indications
- Chronic illnesses requiring long-term medication administration (e.g., chemotherapy)
- Frequent blood transfusions or phlebotomy
- Dialysis
- Pain management via epidural injections
- Administration of nutritional support for those who cannot eat by mouth
- Removal of excess fluids, e.g., in cases of ascites
Preparation
- Fasting for 6-12 hours prior to the procedure
- Adjustments in current medications as instructed by your physician
- Pre-procedure diagnostic tests such as blood work or imaging studies
- Inform your healthcare provider of any allergies, especially to anesthesia
Procedure Description
- Insertion site selection: A suitable site for catheter insertion is chosen and sterilized.
- Anesthesia: Local or general anesthesia is administered to numb the area or make the patient sleep.
- Incision and Placement: A small incision is made, and the catheter is guided into the appropriate vessel or body space.
- Fixing and Testing: The catheter is secured in place and tested for proper function.
- Closure: The incision site is stitched closed, and a portion of the catheter remains externally accessible.
Common tools include scalpels, guidewires, and imaging equipment (e.g., ultrasound, fluoroscopy). Sedation details vary, ranging from local anesthesia to full sedation.
Duration
The procedure typically takes 1-2 hours.
Setting
The procedure is performed in a hospital operating room or an outpatient surgical center.
Personnel
- Surgeon or interventional radiologist
- Anesthesiologist (if general anesthesia is used)
- Nurses
- Surgical technologists
Risks and Complications
- Infection at the insertion site or in the bloodstream
- Blood clots (thrombosis)
- Catheter displacement or blockage
- Bleeding or bruising
- Allergic reactions to anesthesia
- Damage to surrounding tissues or organs
Benefits
- Continuous or frequent access to veins or other body cavities without repeated needle sticks
- Reliable administration of medications and fluids
- Effective blood withdrawal for testing
- Minimization of patient discomfort due to fewer needle insertions Patients typically experience benefits immediately or within a few days.
Recovery
- Keep the insertion site clean and dry
- Follow specific care instructions provided by your healthcare team
- Avoid strenuous activities for a designated period
- Attend follow-up appointments for catheter maintenance and monitoring Expect recovery to take a few days, with follow-up care extending over weeks or even months.
Alternatives
- Peripheral IV lines: Suitable for short-term use, frequent needle insertions needed.
- Port-a-Cath: A device implanted under the skin for long-term venous access.
- PICC lines: Peripherally inserted central catheters, less invasive but prone to dislocation. Each alternative has specific pros and cons regarding patient comfort, risk of complications, and duration of use.
Patient Experience
During the procedure, patients should not feel significant pain due to anesthesia. Post-procedure, mild discomfort or soreness at the incision site is common. Pain management will include prescribed pain relievers and instructions to keep the area clean to prevent infection. Comfort measures such as soft dressings and routine checks will be provided by the healthcare team.