Name of the Procedure:

Injection of Perflutren Lipid Microspheres
Common Names: Ultrasound contrast agent injection
Technical Terms: Intravascular injection of perflutren lipid microspheres (HCPCS Code: Q9957)

Summary

This procedure involves injecting a contrast agent, known as perflutren lipid microspheres, into a patient's bloodstream. The purpose is to enhance the quality of an ultrasound image by improving the contrast of blood flow, making it easier for doctors to diagnose and monitor various medical conditions.

Purpose

The procedure aims to:

• Improve the visibility of cardiac chambers, blood vessels, and other structures during an ultrasound.
• Assist in the diagnosis and eval[b]uation of cardiac diseases, vascular conditions, and certain types of tumors.

Indications

• Poor-quality ultrasound images due to obesity, chest wall deformities, or lung disease.
• Altered baseline echocardiograms where clear distinction of cardiac structures is needed.
• Patients requiring detailed evaluation of cardiac function, wall motion, or blood flow patterns.

Preparation

• No specific fasting required unless combined with other procedures.
• Inform the medical team of all medications being taken, particularly blood thinners.
• Pre-procedure echocardiogram may be conducted.

Procedure Description

1. The patient lies down, and an intravenous (IV) line is inserted into a vein.
2. Perflutren lipid microspheres are injected through the IV.
3. An ultrasound probe is positioned over the target area (e.g., heart, blood vessels).
4. The ultrasound captures enhanced images as the contrast agent circulates.
5. The procedure is monitored in real-time to ensure accurate imaging.

Tools and Equipment:

• Ultrasound machine
• IV line and supplies
• Perflutren lipid microspheres

Anesthesia/Sedation: Typically not required, as the procedure is minimally invasive.

Duration

The procedure generally takes about 30-60 minutes.

Setting

The procedure is typically performed in:

• Hospital radiology departments
• Outpatient imaging centers
• Cardiologist’s office with ultrasound capability

Personnel

• Radiologist or Cardiologist
• Ultrasound technician
• Nursing staff for IV placement and monitoring

Risks and Complications

Common risks:

• Mild allergic reactions (e.g., rash, itching)
• Temporary discomfort at the injection site

Rare but serious complications:

• Severe allergic reactions (anaphylaxis)
• Cardiovascular events in patients with heart disease

Most complications can be managed with immediate medical intervention.

Benefits

• Enhanced clarity and definition of ultrasound images
• More accurate diagnosis and monitoring of cardiac and vascular conditions
• Immediate visualization allows for quicker clinical decision-making

Recovery

• Patients can typically return to normal activities immediately after the procedure.
• Monitor the injection site for any signs of infection or adverse reaction.
• Follow-up appointments may be scheduled to discuss the ultrasound findings.

Alternatives

• Standard ultrasound without contrast agent
• Other imaging modalities such as CT or MRI scans
• Each alternative has its own risks, benefits, and suitability depending on the patient's condition.

Patient Experience

• Minor discomfort or pain during IV insertion.
• Cold or warm sensation as the contrast agent is injected.
• Most patients tolerate the procedure well without significant pain.
• The healthcare team will provide comfort measures and monitor for any adverse reactions.