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Venography, caval, inferior, with serialography, radiological supervision and interpretation

CPT4 code

Name of the Procedure:

Venography, caval, inferior, with serialography, radiological supervision and interpretation

Summary

Venography of the inferior vena cava involves using X-rays and a contrast dye to visualize the inferior vena cava, the large vein carrying deoxygenated blood from the lower body to the heart. The procedure includes creating a series of images (serialography) with radiological oversight and interpretation.

Purpose

  • Medical Condition: To diagnose blood flow abnormalities, blockages, or thrombosis (blood clots) in the inferior vena cava.
  • Goals: To provide a detailed map of the venous system for further diagnosis or surgical planning, ensuring accurate treatment of vascular issues.

Indications

  • Symptoms like leg swelling, pain, or deep vein thrombosis (DVT).
  • Conditions such as inferior vena cava syndrome.
  • Prior history of blood clots or suspected vascular abnormalities.

Preparation

  • Diet/Fasting: Patients may need to fast for several hours before the procedure.
  • Medications: May need to adjust or stop certain medications as per doctor's advice (e.g., blood thinners).
  • Tests: Routine blood tests and a medical history review are typically required.

Procedure Description

  1. Initial Setup: Patient lies on an X-ray table, and an IV line is inserted.
  2. Contrast Injection: A contrast dye is injected into a vein, usually in the groin or arm.
  3. Imaging: X-ray images are taken in a series to capture the dye's flow through the inferior vena cava.
  4. Serialography: Multiple images are generated to provide a detailed view.
  5. Supervision and Interpretation: A radiologist oversees the procedure and interprets the X-ray findings.
  • Tools/Equipment: X-ray machine, contrast dye, fluoroscope.
  • Anesthesia/Sedation: Local anesthesia at the injection site; sedation if necessary for patient comfort.

Duration

Typically takes about 30 minutes to an hour.

Setting

Performed in a hospital radiology department or outpatient imaging center.

Personnel

  • Interventional Radiologist
  • Radiology Technician
  • Nurses
  • Anesthesiologist (if sedation is used)

Risks and Complications

  • Common Risks: Discomfort at injection site, allergic reactions to contrast dye.
  • Rare Risks: Blood clot formation, vein damage, infection, contrast-induced nephropathy (kidney issues).

Benefits

  • Accurate diagnosis of vein blockages or abnormalities.
  • Informative imaging that aids in planning further treatment.
  • Rapid results aiding in timely medical decisions.

Recovery

  • Post-Procedure Care: Observation for a few hours, increased fluid intake to flush out dye.
  • Recovery Time: Usually brief; most patients can resume normal activities within a day.
  • Follow-Up: As directed by physician, typically includes reviews of findings and planning further treatment if necessary.

Alternatives

  • Doppler Ultrasound: Non-invasive but less detailed imaging.
  • CT or MRI Venography: Alternative imaging methods, potentially without contrast dye.
  • Pros/Cons: Alternatives may be less invasive but might not provide as detailed imagery.

Patient Experience

  • During Procedure: Mild discomfort or pressure during IV insertion and dye injection.
  • After Procedure: Temporary soreness at injection site; any discomfort managed with mild pain relievers.
  • Pain Management: Local anesthesia minimizes pain; sedation if patient experiences anxiety or claustrophobia.

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