78445 Non-cardiac vascular flow imaging (ie, angiography, venography)

Name of the Procedure:

Non-cardiac Vascular Flow Imaging (Angiography, Venography)

Summary

Non-cardiac vascular flow imaging involves taking detailed images of blood vessels outside the heart to diagnose issues related to blood flow. These techniques are often referred to as angiography when focusing on arteries and venography when focusing on veins.

Purpose

This procedure helps identify blockages, narrowing, or other abnormalities in the blood vessels. The goal is to diagnose vascular conditions accurately so that appropriate treatment can be planned.

Indications

• Unexplained pain or swelling in the limbs
• Suspected blood clots or deep vein thrombosis (DVT)
• Evaluation of varicose veins
• Monitoring of known vascular conditions or abnormalities
• Screening for arterial diseases, such as peripheral artery disease (PAD)

Preparation

• Fasting for 4-6 hours prior to the procedure
• Possible cessation of certain medications, especially blood thinners
• Pre-procedure blood tests and imaging studies may be required
• Arrangements should be made for transportation, as driving post-procedure is not advised

Procedure Description

1. The patient lies on an imaging table.
2. A local anesthetic is applied to the insertion site.
3. A small incision is made, and a catheter is inserted into a blood vessel.
4. A contrast dye is injected through the catheter to make the blood vessels visible on imaging.
5. X-rays, CT scans, or MRIs are used to capture detailed images of the blood vessels.
6. The catheter is removed, and pressure is applied to stop any bleeding.

Duration

The procedure typically takes about 1-2 hours.

Setting

It is usually performed in a hospital radiology department or a specialized outpatient imaging center.

Personnel

• Radiologist or Interventional Radiologist
• Surgical or Radiologic Technologist
• Nursing staff
• Anesthesiologist or Nurse Anesthetist (if sedation is used)

Risks and Complications

• Allergic reaction to contrast dye
• Infection at the catheter insertion site
• Bleeding or bruising
• Blood vessel damage
• Kidney problems (related to the contrast dye)
• Rarely, blood clots

Benefits

• Accurate diagnosis of vascular conditions
• Ability to plan targeted treatments
• Minimally invasive with relatively quick recovery

Recovery

• Patients are usually monitored for a few hours post-procedure.
• Instructions may include avoiding strenuous activities for a day or two.
• Pain management might involve over-the-counter pain relievers.
• Follow-up appointments will be scheduled to discuss results and next steps.

Alternatives

• Doppler ultrasound (less invasive but less detailed)
• MRI or CT scans without contrast (useful for patients with dye allergies)
• Blood tests and other non-imaging diagnostics

Patient Experience

During the procedure, patients may feel slight pressure or discomfort at the catheter insertion site. The contrast dye might cause a warm sensation. Post-procedure, mild soreness and bruising at the insertion site are common, but severe pain is rare and should be reported to a healthcare provider. Pain management and comfort measures, such as rest and hydration, will help facilitate recovery.