CPT® Code 61623

Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon, concomitant neurological monitoring, and radiologic supervision and interpretation of all angiography required for balloon occlusion and to exclude vascular injury post occlusion

Endovascular temporary balloon arterial occlusion is a specialized medical procedure utilized in the head or neck region, specifically targeting both extracranial and intracranial arteries. This technique involves the temporary occlusion of an artery using a balloon, which is crucial for assessing the feasibility of a subsequent permanent occlusion without risking neurovascular complications, such as stroke. The procedure begins with the selection and puncture of an access artery, followed by the placement of an introducer sheath. This sheath facilitates the introduction of a guidewire, which is navigated to the target vessel under fluoroscopic guidance. A neuroangiography catheter is then advanced over the guidewire, allowing for diagnostic angiography to be performed. This step is essential for confirming any vascular anomalies and evaluating the surrounding vasculature prior to the balloon occlusion. Once the diagnostic phase is complete, the catheter is positioned in the artery intended for occlusion. A guidewire is reintroduced, and the angiography catheter is replaced with a temporary balloon occlusion catheter. Prior to the balloon's deployment, a neurological examination is conducted to ensure the patient's stability. Intra-arterial pressure measurements are taken to assess the hemodynamic status of the target vessel. The balloon is then inflated, effectively occluding the artery, and contrast material is injected to verify the occlusion. Following this, arterial pressures are measured again, and another neurological examination is performed to confirm that the patient remains neurologically stable. Over the next 30 minutes, timed neurological evaluations and arterial pressure measurements are conducted to monitor for any changes in neurological status. After this observation period, the temporary occlusion balloon is deflated and removed, and a completion angiogram is performed to rule out any vascular injury that may have occurred during the temporary occlusion procedure.