78610 Brain imaging, vascular flow only

Name of the Procedure:

Brain Imaging, Vascular Flow Only

• Common names: Cerebral Angiography, Brain Vascular Imaging
• Technical term: Intracranial Angiography

Summary

Brain imaging for vascular flow is a diagnostic procedure that visualizes the blood vessels in the brain. It helps to detect abnormalities such as aneurysms, blockages, or vascular malformations by providing detailed images of the cerebral blood flow.

Purpose

• Medical Conditions: Commonly addresses conditions like aneurysms, stroke, arteriovenous malformations (AVMs), and other vascular disorders.
• Goals: To diagnose vascular abnormalities, guide treatment decisions, and plan surgical or interventional procedures.

Indications

• Symptoms: Severe headaches, unexplained neurological symptoms, dizziness, or vision problems.
• Conditions: Suspected stroke, transient ischemic attacks (TIAs), brain aneurysms, or other vascular malformations.
• Criteria: Presence of risk factors for cerebrovascular disease, such as hypertension, smoking, or family history.

Preparation

• Pre-procedure Instructions: Patients may need to fast for several hours before the procedure. They should avoid certain medications, particularly blood thinners, unless advised otherwise by their healthcare provider.
• Diagnostic Tests: Blood tests, a review of medical history, and possibly a preliminary MRI or CT scan.

Procedure Description

1. Pre-procedure Setup: The patient lies on an X-ray table; an intravenous (IV) line might be started.
2. Sedation: Mild sedation and local anesthesia may be used to numb the insertion site, usually in the groin.
3. Catheter Insertion: A catheter is inserted into a large artery (e.g., femoral artery) and guided through the blood vessels to the brain.
4. Contrast Injection: A contrast dye is injected through the catheter to make the blood vessels visible on imaging.
5. Imaging: X-ray images are taken to capture the flow of the contrast dye through the cerebral blood vessels.
6. Catheter Removal: The catheter is carefully removed, and pressure is applied to the insertion site to prevent bleeding.

• Tools Used: Catheter, contrast dye, X-ray machine.
• Anesthesia: Local anesthesia at the insertion site, mild sedation as needed.

Duration

Typically, the procedure lasts about 1–2 hours.

Setting

Performed in a hospital's radiology department or specialized imaging center.

Personnel

• Interventional radiologist or neuroradiologist
• Radiology technicians
• Nurses
• Anesthesiologist (if sedation is used)

Risks and Complications

• Common Risks: Bruising or bleeding at the catheter insertion site, allergic reaction to contrast dye.
• Rare Risks: Stroke, blood vessel damage, kidney damage from contrast, infection.

Benefits

• Expected Benefits: Accurate diagnosis of vascular conditions, guiding effective treatment.
• Timeframe: Immediate visualization and diagnosis during the procedure.

Recovery

• Post-procedure Care: Bed rest for several hours to prevent bleeding at the insertion site, hydration to flush out the contrast dye.
• Recovery Time: Typically, patients can resume normal activities within 1-2 days.
• Follow-Up: Possible follow-up imaging or appointments to discuss findings and treatment options.

Alternatives

• Other Options: Non-invasive imaging techniques such as MRI angiography (MRA) or CT angiography (CTA).
• Pros and Cons: Non-invasive methods are less risky but may not provide as detailed images as cerebral angiography.

Patient Experience

• During Procedure: The patient might feel slight discomfort from the IV and catheter insertion, and a warm sensation when the contrast dye is injected.
• Post-procedure: Possible mild soreness at the insertion site, generally no significant pain. Pain management through mild pain relievers as needed.