Angiography, adrenal, unilateral, selective, radiological supervision and interpretation
CPT4 code
Name of the Procedure:
Angiography, adrenal, unilateral, selective, radiological supervision, and interpretation
- Common Name: Adrenal Angiography
- Technical Term: Selective Unilateral Adrenal Angiography
Summary
Adrenal angiography is a specialized imaging procedure used to visualize the blood vessels of one of the adrenal glands. It involves the selective injection of contrast dye into the blood vessels and capturing radiographic images to detect any abnormalities.
Purpose
Adrenal angiography helps diagnose conditions related to the adrenal glands, such as tumors, hyperplasia, or vascular abnormalities. The procedure aims to provide detailed images to guide further treatment decisions.
Indications
- Adrenal tumors (e.g., pheochromocytomas)
- Unexplained hypertension
- Adrenal hyperplasia
- Suspected adrenal hemorrhage
- Evaluation before adrenal gland surgery
Preparation
- Patients are usually required to fast for 6-8 hours before the procedure.
- They may need to stop certain medications, particularly blood thinners, as advised by their doctor.
- Pre-procedure diagnostic tests may include blood tests, blood pressure measurements, and allergies to contrast dye assessment.
Procedure Description
- The patient is positioned on a radiographic table.
- A local anesthetic is administered to numb the insertion site, usually in the groin area.
- A small incision is made and a catheter is inserted into the femoral artery.
- Using fluoroscopy (real-time X-ray imaging), the catheter is navigated to the blood vessels of the adrenal gland.
- Contrast dye is injected through the catheter to highlight the adrenal blood vessels.
- Radiographic images are taken to capture the blood flow and structure of the adrenal glands.
- The catheter is then removed, and pressure is applied to the insertion site to prevent bleeding.
Duration
The procedure typically takes about 1-2 hours.
Setting
Adrenal angiography is performed in a hospital's radiology department or an outpatient clinic equipped with specialized imaging technology.
Personnel
- Interventional Radiologist
- Radiologic Technologist
- Nurse
- Anesthesiologist (if sedation is used)
Risks and Complications
- Common risks: bruising, bleeding, and infection at the catheter insertion site.
- Rare but serious risks: allergic reaction to contrast dye, kidney damage, arterial injury, or blood clot formation.
Benefits
- Provides detailed visualization of adrenal blood vessels, aiding in accurate diagnosis and treatment planning.
- Helps identify abnormal growths or blood flow issues.
- Results can be realized immediately after the procedure and assist in making timely medical decisions.
Recovery
- Patients may need to lie flat for a few hours post-procedure to prevent bleeding from the catheter site.
- They will receive instructions to monitor the site for signs of infection or excessive bleeding.
- Normal activities can generally be resumed within 24-48 hours, but heavy lifting and strenuous activities should be avoided for a few days.
- Follow-up appointments may be scheduled to discuss results and further treatment.
Alternatives
- Non-invasive imaging techniques such as CT or MRI scans.
- Blood tests for hormone levels to indirectly assess adrenal function.
- Each alternative has its pros and cons; CT and MRI are less invasive but may not provide as detailed vascular information.
Patient Experience
During the procedure, patients might feel some discomfort or pressure at the insertion site and a warm sensation when the dye is injected. After the procedure, they will be monitored for a few hours to ensure there are no immediate complications. Pain or discomfort at the insertion site can be managed with over-the-counter pain medication.