Name of the Procedure:

Common Term: Intravascular Ultrasound Catheter
Medical Term: Catheter, Intravascular Ultrasound (HCPCS C1753)

Summary

Intravascular ultrasound (IVUS) is a diagnostic procedure that uses a special catheter equipped with an ultrasound probe to visualize the inside of blood vessels. This procedure provides detailed images of the vessel walls and can help assess conditions like blockages or atherosclerosis.

Purpose

IVUS is used to:

• Diagnose and evaluate the severity of blockages in blood vessels.
• Assess the need for interventions like stenting or angioplasty.
• Help guide the placement of stents or other devices during vascular procedures.
• Monitor the success of treatments and detect potential complications.

Indications

IVUS is indicated for patients with:

• Symptoms of coronary artery disease (e.g., chest pain, shortness of breath).
• Suspicion of peripheral vascular disease.
• Abnormal findings on other imaging tests like angiography.
• Previous vascular interventions requiring follow-up assessments.

Preparation

• Patients are typically advised to fast for several hours prior to the procedure.
• Certain medications may need to be adjusted or paused, especially anticoagulants.
• Blood tests and imaging studies may be conducted beforehand to evaluate overall health and plan the procedure.

Procedure Description

1. The patient is brought to the catheterization lab or operating room.
2. Local anesthesia or sedation is administered.
3. A small incision is made, usually in the groin or arm, to access a blood vessel.
4. A guidewire is introduced into the vessel, followed by the IVUS catheter.
5. The catheter is advanced to the area of interest.
6. Ultrasound images are captured and displayed in real-time, allowing for detailed assessment.
7. Upon completion, the catheter and guidewire are removed, and the incision site is closed.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

IVUS is performed in:

• Hospital catheterization labs
• Outpatient clinics with vascular imaging facilities
• Surgical centers specializing in vascular procedures

Personnel

• Interventional cardiologist or vascular surgeon
• Trained nursing staff
• Radiologic technologists
• Anesthesiologist or nurse anesthetist (if sedation is used)

Risks and Complications

• Common risks include bleeding or bruising at the catheter insertion site.
• Rare risks include vessel injury, blood clots, infection, or allergic reactions to contrast dye or anesthesia.
• Any complications are managed promptly by the medical team.

Benefits

• Provides precise images of blood vessels, aiding in accurate diagnosis and treatment planning.
• Minimally invasive with a quick recovery time.
• Helps in making informed decisions for interventions like stenting.

Recovery

• Patients are monitored for several hours post-procedure.
• Instructions for care at the incision site and activities to avoid are provided.
• Most patients can return to normal activities within a day or two.
• Follow-up appointments may be scheduled to review results and plan further care.

Alternatives

• Non-invasive imaging tests like CT angiography or MRI.
• Conventional angiography without ultrasound guidance.
• Each alternative has its pros and cons in terms of accuracy, risk, and patient comfort.

Patient Experience

• Mild discomfort at the insertion site during and after the procedure.
• Patients may feel pressure as the catheter is navigated through the vessels.
• Sedation helps minimize discomfort, and pain relief is provided as needed.