CPT® Code 37195

1. Indications

The procedure of cerebral thrombolysis by intravenous infusion is indicated for specific medical conditions where the dissolution of blood clots in the brain is necessary to restore blood flow. The following are the primary indications for this procedure:

• Acute Ischemic Stroke - This is the most common indication for cerebral thrombolysis, where a blood clot obstructs blood flow to a part of the brain, leading to potential neurological deficits.
• Cerebral Venous Sinus Thrombosis - In some cases, thrombolysis may be indicated for the treatment of clots in the cerebral venous sinuses, which can cause increased intracranial pressure and other complications.

2. Procedure

The procedure for cerebral thrombolysis involves several critical steps to ensure effective treatment and patient safety. The following outlines the procedural steps:

• Step 1: Establish Venous Access - The physician begins by placing a venous access device, such as a needle or catheter, into a suitable vein. This access point is essential for the administration of the thrombolytic agent and must be secured to ensure proper infusion throughout the procedure.
• Step 2: Infusion of Thrombolytic Agent - Once venous access is established, the physician initiates the intravenous infusion of the thrombolytic agent. This medication is specifically designed to break down the fibrin in blood clots, thereby restoring blood flow to the affected area of the brain. The infusion is typically administered at a controlled rate, and the physician closely monitors the patient’s response during this phase.
• Step 3: Continuous Neurological Monitoring - Throughout the infusion process, the physician continuously monitors the patient's neurological function. This monitoring is crucial to detect any changes in the patient's condition, which may indicate complications or the need for additional interventions.
• Step 4: Post-Infusion Monitoring and Medication Administration - After the thrombolytic agent has been infused, the physician continues to monitor the patient's neurological status. If necessary, additional intravenous medications may be administered to manage symptoms or complications that arise during the recovery phase.

3. Post-Procedure

Following the cerebral thrombolysis procedure, the patient requires careful monitoring to assess the effectiveness of the treatment and to identify any potential complications. The healthcare team will continue to observe the patient's neurological function closely, looking for signs of improvement or any adverse reactions to the thrombolytic agent. Recovery may vary depending on the individual patient's condition and the extent of the ischemic event. Additional supportive care and medications may be provided as needed to ensure optimal recovery and to address any ongoing medical needs. The healthcare provider will also discuss follow-up care and any necessary rehabilitation services to support the patient's recovery process.