CPT® Code 0340T

Deleted

1. Indications

The procedure of percutaneous cryoablation of pulmonary tumor(s) is indicated for specific clinical scenarios where traditional surgical options are not viable. The following conditions warrant the use of this procedure:

• Poor Patient Health - Patients who are not in optimal health and may not tolerate invasive surgical procedures.
• Advanced Tumors - Tumors that are too large or located in areas that make surgical removal impractical or impossible.
• Solitary Lesions - Small, solitary pulmonary lesions that require radical destruction but cannot be surgically resected.

2. Procedure

The percutaneous cryoablation procedure involves several critical steps to ensure effective treatment of the pulmonary tumors. Each step is designed to maximize patient safety and treatment efficacy.

• Step 1: Anesthesia Administration - The procedure begins with the administration of local anesthesia to the skin and connective tissue down to the pleura. This step is crucial for minimizing discomfort during the insertion of the cryoprobe. In some cases, moderate sedation may also be provided to enhance patient comfort throughout the procedure.
• Step 2: Imaging Guidance - Imaging guidance, typically through computed tomography (CT), is employed to accurately locate the tumor or target area within the lung. This imaging is essential for ensuring precise placement of the cryoprobe and for monitoring the procedure in real-time.
• Step 3: Cryoprobe Insertion - Once the target area is identified, a cryoprobe is carefully inserted into the tumor or designated tissue area. The precise placement of the cryoprobe is critical for effective treatment and is guided by the imaging obtained in the previous step.
• Step 4: Cryoablation Process - The cryoprobe delivers high-pressure argon or helium gases into the targeted tissue, initiating the freezing process. This is typically performed in cycles, with two initial freeze-thaw cycles lasting five minutes each, followed by a longer freeze-thaw cycle of ten minutes. This controlled freezing creates an ice ball within the tissue, effectively destroying the tumor cells.
• Step 5: Post-Procedure Monitoring - After the cryoablation is completed, the patient is monitored for any immediate post-procedure effects. The ice ball created during the procedure will remain in the body and will be gradually reabsorbed, leading to the destruction of the tumor over time.

3. Post-Procedure

Following the percutaneous cryoablation procedure, patients are typically monitored for any immediate complications or adverse effects. Recovery may vary depending on the individual patient's health status and the extent of the procedure. Patients may experience some discomfort or mild pain at the site of the cryoablation, which can usually be managed with standard pain relief measures. It is important for patients to follow any specific post-procedure care instructions provided by their healthcare team, which may include activity restrictions and follow-up imaging to assess the effectiveness of the treatment. The ice ball created during the procedure will eventually be reabsorbed by the body, leading to the gradual destruction of the tumor cells, and patients may require ongoing monitoring to evaluate the long-term outcomes of the procedure.