Name of the Procedure:

Common Name: Catheter thrombectomy/embolectomy
Technical Term: Percutaneous thrombectomy/embolectomy using catheter (HCPCS Code: C1757)

Summary

Catheter thrombectomy/embolectomy is a medical procedure to remove blood clots from blood vessels. Using a specialized catheter, doctors can break up or remove clots that are causing blockages.

Purpose

The procedure addresses conditions like deep vein thrombosis (DVT) or arterial embolism where blood clots obstruct blood flow. The goals are to restore normal blood flow, prevent severe complications like tissue damage or stroke, and alleviate symptoms such as pain and swelling.

Indications

• Presence of deep vein thrombosis (DVT)
• Arterial embolism
• Pulmonary embolism
• Acute limb ischemia
• Non-resolving blood clots despite medication
• Symptoms like severe pain, swelling, or bluish skin discoloration

Preparation

• Patients may need to fast for a few hours before the procedure.
• Certain medications such as blood thinners might need to be adjusted.
• Pre-procedure diagnostic tests like ultrasounds or CT scans to locate the clot.

Procedure Description

1. Step 1: The patient is typically given a local anesthetic or sedation.
2. Step 2: A small incision is made, usually in the groin area, to access the affected blood vessel.
3. Step 3: A catheter is threaded through the blood vessels to the site of the clot.
4. Step 4: Tools within the catheter dissolve or remove the clot.
5. Step 5: The catheter is removed, and the incision is closed.

Tools used include guidewires, balloon catheters, and thrombolytic agents. Sedation or local anesthesia is usually applied to minimize discomfort.

Duration

The procedure typically takes between 1 to 3 hours, depending on the clot's size and location.

Setting

Performed in a hospital setting, often in a specialized radiology or surgical suite.

Personnel

• Interventional Radiologist or Vascular Surgeon
• Nursing staff
• Anesthesiologist or Nurse Anesthetist
• Radiologic Technicians

Risks and Complications

• Bleeding or infection at the incision site
• Damage to the blood vessel
• Reaction to contrast dye or anesthesia
• Recurrence of blood clots
• Rare but serious complications like stroke

Benefits

• Immediate relief from symptoms such as pain and swelling
• Reduced risk of severe complications like tissue damage or stroke
• Quick restoration of normal blood flow

Recovery

• Patients might need to stay in the hospital for a few hours to a day for observation.
• Instructions include keeping the incision area clean and dry and avoiding strenuous activities for a few days.
• Follow-up appointments to monitor recovery and clot recurrence.

Alternatives

• Medication-only treatment with anticoagulants or thrombolytics.
• Surgical thrombectomy (open surgery).
• Pros: Non-invasive options like medication pose less immediate risk and recovery time.
• Cons: They might be less effective if immediate clot removal is necessary.

Patient Experience

During the procedure, patients might feel some discomfort but usually no severe pain due to sedation or anesthesia. Post-procedure, there may be mild pain or bruising at the catheter site, manageable with pain relief measures. Patients can typically resume normal activities within a few days, but detailed recovery instructions will be provided.