Stent placement for vena caval obstruction

Summary

The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on stent placement for vena caval obstruction.

Description

Vena caval obstruction is narrowing or occlusion of the caval veins (the inferior vena cava or the superior vena cava), which return blood from the body to the heart. It is most commonly caused by cancer, especially lung cancer. Patients with malignant vena caval obstruction are very unwell and have a short life expectancy.

Standard treatments for malignant caval obstruction include radiotherapy and chemotherapy. These can cause severe adverse events and response to treatment may take several weeks. Stent placement can replace or supplement these treatments.

Stent placement for vena caval obstruction is a minimally invasive procedure that involves inserting a catheter into a large vein, usually in the groin, and passing it into the narrowed area under X-ray control. A stent, which may be self-expanding or balloon-dilated, is then positioned across the area of narrowing to relieve it.

NICE Pathways

This guidance has been incorporated into the following NICE Pathways, along with other related guidance and products.

Visit the NICE Pathway: lung cancer

OPCS4.6 Code(s):

L79.3 Insertion of stent into vena cava NEC

Note: Use a supplementary code for placement of stent (L76, L89, O20)

A code from category L76.- Endovascular placement of stent or L89.- Other endovascular placement of stent or O20.- Endovascular placement of stent graft is added to specify the type and number of stents used.

and

Y53.1 Approach to organ under radiological control

_{The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS. The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. www.connectingforhealth.co.uk/clinicalcoding}

Details

Contact details:

Links:

	IPG79 Stent placement for vena caval obstruction: guidance	28 July 2004
	IPG79 Stent placement for vena caval obstruction: guidance (web format)	04 February 2011
	IPG79 Stent placement for vena caval obstruction: understanding NICE guidance	28 July 2004
	IPG79 Gosod stent i drin rhwystr yn y fena cafa: deall canllawiau NICE	19 May 2009
	IPG79 Stent placement for vena caval obstruction: distribution list	28 July 2004
	Interventional procedure consultation document - stent placement for vena caval obstruction	24 February 2004
	Overview of stent placement for vena caval obstruction	20 February 2004