Venography, renal, unilateral, selective, radiological supervision and interpretation
CPT4 code
Name of the Procedure:
Venography, Renal, Unilateral, Selective, Radiological Supervision and Interpretation
Summary
Venography of the renal vein is a diagnostic imaging procedure that involves injecting a contrast dye through a catheter to visualize the renal veins on X-ray. This is done unilaterally (one side) and selectively targets the renal veins needing evaluation.
Purpose
Venography is used to diagnose conditions affecting the renal veins, such as blood clots, tumors, or anomalies in blood flow. The primary goal is to provide a clear image of the renal veins to aid in diagnosis and treatment planning.
Indications
- Suspected renal vein thrombosis
- Evaluation of renal vein abnormalities
- Investigation of kidney-related high blood pressure
- Pre-surgical mapping of renal veins for surgical planning
Preparation
- Patients may be instructed to fast for several hours before the procedure.
- Allergies to contrast dye should be reported to the healthcare provider.
- Blood tests to assess kidney function and clotting ability might be conducted beforehand.
Procedure Description
- The patient is positioned on an X-ray table.
- An intravenous catheter is inserted into a vein, often in the groin.
- A contrast dye is injected through the catheter into the renal veins.
- X-ray images are taken to track the flow of the dye and visualize the renal veins.
- The catheter is removed, and pressure is applied to the insertion site to prevent bleeding.
Technologies used include X-ray machines and intravenous catheters. Local anesthesia is typically employed at the catheter insertion site.
Duration
The procedure typically takes about 30 minutes to 1 hour.
Setting
Venography is performed in a hospital radiology department or an outpatient clinic with specialized imaging facilities.
Personnel
- Radiologist (performing and interpreting the imaging)
- Radiologic technologist
- Nurse (assisting with preparation and post-procedure care)
Risks and Complications
Common risks include:
- Allergic reactions to contrast dye
- Bleeding or bruising at the catheter insertion site
Rare risks:
- Kidney damage from contrast dye
- Blood clots
- Infection at the puncture site
Benefits
- Accurate diagnosis of renal vein conditions
- Guided planning for appropriate treatments or surgical interventions
- Immediate visualization results seen on X-ray
Recovery
- Patients are monitored for a short period post-procedure.
- Instructions include avoiding strenuous activities for 24 hours.
- Drink plenty of fluids to help flush out the contrast dye.
- Follow-up appointment may be scheduled to discuss results and next steps.
Alternatives
- Duplex ultrasound of the renal veins (non-invasive but less detailed)
- Magnetic Resonance Angiography (MRA) or Computed Tomography Angiography (CTA) as alternative imaging techniques
Pros of alternatives:
- Non-invasive options like ultrasound
- Different imaging modalities might be better for certain patients (e.g., those with kidney impairments)
Cons of alternatives:
- May provide less detail or require additional procedures for conclusive diagnosis
Patient Experience
- Mild pressure or discomfort at the catheter insertion
- A warm or flushed feeling as the dye is injected
- Post-procedure discomfort may include slight soreness or bruising at the insertion site
- Pain management includes over-the-counter pain relievers and ice packs if needed