The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Endovascular stent insertion for intracranial atherosclerotic disease.
This document replaces previous guidance on Endovascular stent insertion for intracranial atherosclerotic disease (NICE interventional procedure guidance IPG 233, October 2007).
Intracranial atherosclerotic disease (ICAD) is the narrowing of the arteries inside the head that supply blood to the brain. ICAD is associated with an increased risk of stroke. In this procedure, a balloon catheter is inserted into an artery in the arm or leg, guided to the affected artery and inflated to open up the narrowing. A small tube made of metal mesh, called a stent, is then positioned at the site of the narrowing to maintain improved blood flow.
L31.4 Percutaneous transluminal insertion of stent into carotid artery
L35.3 Percutaneous transluminal insertion of stent into cerebral artery
A code from category L76 Endovascular placement of stent or L89 Other endovascular placement of stent should be added to specify the type and number of stents used.
Y53.- Approach to organ under image control
In addition ICD-10 code I67.2 Cerebral atherosclerosis is assigned.
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.