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Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study
CPT4 code
Name of the Procedure:
Duplex Scan of Arterial Inflow and Venous Outflow for Preoperative Vessel Assessment; Complete Unilateral Study
- Common names include: "Duplex Ultrasound" or "Vascular Ultrasound for Dialysis Access Planning"
Summary
A Duplex scan is a non-invasive ultrasound procedure that evaluates blood flow in arteries and veins. Specifically, this scan is used to assess the suitability of blood vessels before creating a hemodialysis access point, such as an arteriovenous (AV) fistula or graft.
Purpose
- Medical condition: Used for patients with chronic kidney disease who require hemodialysis.
- Goals: To identify the best blood vessels for creating a reliable hemodialysis access point, ensuring proper blood flow and reducing complications.
Indications
- Symptoms: Patients with end-stage renal disease needing hemodialysis.
- Criteria: Patients scheduled for the creation of an AV fistula or graft.
Preparation
- Instructions: Typically, no fasting or specific preparations are required.
- Assessments: Pre-scan examination and history of vascular health.
Procedure Description
- Preparation: Patient lies on an examination table, and the area of the body to be scanned is exposed.
- Process: A clear gel is applied to the skin to help with the transmission of sound waves.
- Ultrasound: A handheld device (transducer) is moved over the area. High-frequency sound waves create images of the blood vessels on a monitor.
- Assessment: Both arterial inflow and venous outflow are evaluated for blood flow, vessel diameter, and presence of blockages or abnormalities.
Duration
The procedure typically takes about 30 to 45 minutes.
Setting
Performed in an outpatient clinic, hospital imaging department, or specialized vascular lab.
Personnel
- Technician: Ultrasound technologist.
- Physician: Often a vascular surgeon or radiologist interprets the results.
Risks and Complications
- Common risks: None, as it is non-invasive.
- Rare risks: Possible discomfort from the pressure of the transducer.
Benefits
- Benefits: Provides critical information about the blood vessels, helping to avoid potential complications during hemodialysis access surgery.
- Realization: Immediate understanding of vascular condition post-scan.
Recovery
- Care: No special post-procedure care required.
- Recovery Time: Immediate; patients can resume normal activities right after.
Alternatives
- Options: Magnetic Resonance Angiography (MRA) or Computed Tomography Angiography (CTA).
- Comparison: These alternatives provide more detailed images but may involve contrast agents and radiation exposure.
Patient Experience
- During Procedure: Generally painless. You may feel mild pressure from the transducer.
- After Procedure: No pain; comfort measures rarely needed since it’s non-invasive.