Name of the Procedure:

Balloon Dilatation Catheter, Non-Vascular (HCPCS Code: C1726)
Common Name: Non-Vascular Balloon Dilatation
Technical Term: Non-Vascular Angioplasty, Percutaneous Transluminal Balloon Dilatation

Summary

A non-vascular balloon dilatation is a medical procedure in which a balloon-tipped catheter is inserted into a narrowed or blocked non-vascular passageway (e.g., bile duct, urinary tract) and inflated to widen the passageway. This helps improve the flow of fluids or waste through the duct or passage.

Purpose

The procedure is employed to address conditions where non-vascular passageways are constricted or obstructed due to various reasons, such as scarring, tumors, or congenital anomalies.
Goals:

• To restore normal flow through the obstructed passage
• To alleviate symptoms such as pain or infection caused by the blockage
• To avoid the need for more invasive surgical interventions

Indications

• Obstruction of the bile ducts due to gallstones or tumors
• Urinary tract obstructions due to strictures, stones, or tumors
• Esophageal strictures
• Other non-vascular strictures or blockages

Preparation

• Fasting for a certain period before the procedure, usually 6-8 hours
• Adjusting or stopping specific medications as per doctor's instructions, particularly blood thinners
• Diagnostic tests such as ultrasound, CT scans, or MRI to locate the obstruction

Procedure Description

1. An initial assessment is conducted with imaging techniques to guide the catheter placement.
2. The patient is positioned appropriately, and the area is sterilized.
3. Local anesthesia or mild sedation is administered, depending on the location and complexity of the procedure.
4. A small incision may be made to insert the catheter into the obstructed passageway.
5. The balloon-tipped catheter is guided to the site of narrowing under imaging guidance such as fluoroscopy.
6. Once in place, the balloon is inflated to dilate the passageway.
7. The balloon is then deflated and removed, sometimes leaving a stent to maintain the dilation.
8. Final imaging is done to confirm the success of the dilation.

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on the complexity and location of the obstruction.

Setting

Non-vascular balloon dilatation is usually performed in a hospital or outpatient surgical center under the supervision of specialized medical professionals.

Personnel

• Interventional radiologist or trained specialist
• Nurses
• Radiology technicians
• Anesthesiologist (if sedation or general anesthesia is required)

Risks and Complications

• Infection at the insertion site
• Bleeding or bruising
• Perforation of the passageway
• Allergic reactions to contrast dye or anesthesia
• Re-narrowing of the passageway over time

Benefits

• Non-invasive or minimally invasive compared to surgical options
• Quick relief of symptoms
• Rapid recovery time
• Low risk compared to open surgical procedures

Recovery

• Patients are usually monitored for a few hours post-procedure
• Pain management, if required, is typically minimal
• Instructions to avoid heavy lifting or strenuous activity for a few days
• Follow-up imaging to assess the success of the procedure and detect any complications
• Follow-up appointments to ensure that the passageway remains open

Alternatives

• Surgical dilation or removal of obstructions
• Endoscopic procedures such as ERCP (Endoscopic Retrograde Cholangiopancreatography) for bile duct issues
• Medication management for certain conditions
• Each alternative has its own set of risks, benefits, and effectiveness depending on the patient's condition

Patient Experience

During the procedure, the patient may feel minimal discomfort due to local anesthesia. There might be a sensation of pressure when the balloon is inflated. Post-procedure, mild pain or tenderness at the insertion site is common but usually manageable with over-the-counter pain relief. Most patients can resume normal activities within a few days, following their doctor’s instructions.