Name of the Procedure:

Catheter Ablation, Non-Cardiac, Endovascular (Implantable)
Common Names: Endovascular Ablation, Vascular Catheter Ablation, Implantable Catheter Ablation
Technical Term: C1888 - Catheter, ablation, non-cardiac, endovascular (implantable)

Summary

Catheter ablation for non-cardiac purposes is a minimally invasive procedure used to treat various vascular disorders. It involves inserting a catheter— a thin, flexible tube—into a blood vessel to deliver treatment directly to the area of concern. This procedure does not target the heart but other regions where abnormal tissue or growths need to be ablated or destroyed.

Purpose

Medical Conditions Addressed:

• Vascular malformations
• Chronic venous insufficiency
• Tumors or abnormal growths within blood vessels

Goals/Expected Outcomes:

• Eliminate or reduce abnormal tissue
• Improve blood flow
• Relieve symptoms associated with the vascular condition

Indications

Specific Symptoms or Conditions:

• Pain or swelling in the affected limb
• Chronic wounds or ulcers due to poor blood flow
• Vascular tumors or malformations

Patient Criteria:

• Patients who have not responded to conservative treatments
• Suitable vascular anatomy for catheter access
• Generally good health to tolerate a minimally invasive procedure

Preparation

Pre-procedure Instructions:

• Fasting for 6-8 hours before the procedure
• Adjustment or temporary cessation of certain medications, especially blood thinners
• Pre-procedural imaging tests like an ultrasound or MRI to map the vascular structure

Diagnostic Tests:

• Blood tests to check clotting function and general health
• Pre-procedure imaging such as Doppler ultrasound or MRI

Procedure Description

Step-by-Step Explanation:

1. Patient is positioned and local anesthesia is administered at the catheter insertion site.
2. A small incision is made to access the blood vessel.
3. A catheter is inserted through the incision and navigated to the target area using imaging guidance.
4. Ablation energy (e.g., radiofrequency, laser, or microwave) is delivered through the catheter to destroy abnormal tissue.
5. The catheter is removed, and the incision site is closed.

Tools/Equipment:

• Ablation catheter
• Imaging equipment (e.g., fluoroscopy, ultrasound)
• Ablation equipment (e.g., radiofrequency generator)

Anesthesia/Sedation:

• Local anesthesia at the insertion site
• Sedation as needed for patient comfort

Duration

Typically ranges from 1 to 3 hours, depending on the complexity of the procedure and the specific area being treated.

Setting

Performed in a hospital's interventional radiology suite, catheterization lab, or a specialized outpatient surgical center.

Personnel

• Interventional Radiologist or Vascular Surgeon
• Anesthesiologist or Nurse Anesthetist
• Radiologic Technologist
• Scrub Nurse or Technologist

Risks and Complications

Common Risks:

• Pain or discomfort at the insertion site
• Bleeding or bruising

Rare Risks:

• Infection at the incision site
• Damage to blood vessels
• Blood clots
• Adverse reactions to anesthesia

Management: Successful mitigation of complications usually involves medication, additional procedures, or close monitoring.

Benefits

Expected Benefits:

• Significant reduction or elimination of symptoms
• Improved quality of life Timeframe: Benefits can be evident within days to weeks following the procedure.

Recovery

Post-procedure Care:

• Bandaging or dressings over the incision site
• Prescription of pain management medications if needed

Recovery Time:

• Typically ranges from a few days to a couple of weeks
• Restrictions on vigorous activities
• Follow-up appointments scheduled to monitor recovery

Alternatives

Other Treatment Options:

• Conservative management (e.g., compression stockings, medications)
• Open surgical removal of abnormal tissue or tumors Pros and Cons:
• Conservative methods are less invasive but may be less effective for severe conditions.
• Open surgery can be more definitive but involves longer recovery times and higher risk.

Patient Experience

During the Procedure:

• Mild discomfort from local anesthesia injection
• Conscious with possible sensations of pressure during catheter manipulation

Post-procedure:

• Mild soreness at the catheter insertion site
• Pain management with over-the-counter or prescription medications
• Encouraged to rest and limit physical activity for a short period