Name of the Procedure:

Introducer/Sheath Placement, Non-Guiding, Non-Intracardiac Electrophysiological, Non-Laser (HCPCS Code: C1894)

Summary

This procedure involves the insertion of a sheath, or introducer, into a blood vessel to allow easy access for other medical instruments. This specific type of sheath is used for general vascular access rather than for guiding catheters or intracardiac procedures.

Purpose

Introducer/sheath placements are typically performed to facilitate the insertion of medical devices into blood vessels for treatments, diagnostics, or other interventions. The goal is to provide a clear and safe pathway for instruments to reach the targeted area within the vascular system.

Indications

• Need for vascular access during diagnostic imaging or treatment.
• Infusion of medications or fluids.
• Requirements for repeated vascular access.
• Patients needing a large-bore catheter for specific treatments.

Preparation

• Patients may need to fast for a few hours prior to the procedure.
• Adjustments in medication might be necessary, especially blood thinners.
• Diagnostic tests like blood work or imaging may be performed to assess the patient's condition and vessel anatomy.

Procedure Description

1. The patient is positioned, and the insertion area is cleaned and sterilized.
2. Local anesthesia is administered to numb the insertion site.
3. A small incision is made to expose the blood vessel.
4. A guidewire is inserted into the vessel.
5. The introducer/sheath is then advanced over the guidewire into the vessel.
6. Medical instruments or catheters can now be passed through the sheath into the vessel for further intervention.
7. The sheath is secured in place or removed, depending on its intended use.

Duration

The procedure typically takes about 30 minutes but can vary depending on the complexity and reason for access.

Setting

It is usually performed in a hospital, surgical center, or specialized outpatient clinic.

Personnel

• Interventional radiologist or vascular surgeon.
• Nurses.
• Anesthesiologist (if general anesthesia or sedation is required).

Risks and Complications

• Infection at the insertion site.
• Bleeding or hematoma formation.
• Vessel injury.
• Rarely, blood clots or embolism.
• Allergic reactions to anesthesia.

Benefits

• Facilitates easy and safe vascular access.
• Reduces the need for repeated needle sticks.
• Improves outcomes for patients needing regular treatments or diagnostics involving vascular access.

Recovery

• Patients might need to rest for a few hours post-procedure.
• Instructions regarding wound care and monitoring for signs of infection or complications will be provided.
• Most patients can resume normal activities within a day but should avoid strenuous activities for a couple of days.
• Follow-up appointments might be scheduled to ensure proper healing.

Alternatives

• Standard intravenous (IV) access, for less invasive access needs.
• Central venous catheter placement, for long-term access.
• Peripheral or central line insertion, depending on the intended use.
• Pros and cons of these alternatives generally depend on the specific medical needs and the ease of access required.

Patient Experience

• Patients will feel a pinch or slight discomfort when the local anesthesia is administered.
• During the procedure, patients might feel pressure but usually no sharp pain.
• Post-procedure soreness at the insertion site is common and can be managed with over-the-counter pain medications.
• Most patients experience minimal discomfort and can return to daily activities shortly after.