15860 Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft

Name of the Procedure:

Intravenous Injection of Agent to Test Vascular Flow in Flap or Graft
Common Name: Fluorescein Angiography
Technical Term: Intravenous Fluorescein Injection for Vascular Assessment

Summary

In this procedure, a fluorescent dye (like fluorescein) is injected into a vein, typically in the arm. The dye travels through the bloodstream and provides a visible way to assess the blood flow in a surgical flap or graft. This helps doctors evaluate the health and viability of the tissue.

Purpose

This procedure is used to monitor the blood flow in newly attached or repaired tissue, such as skin flaps or grafts. The goal is to ensure the tissue is receiving adequate blood supply, which is crucial for its survival and successful integration.

Indications

• Post-surgical assessment of a flap or graft
• Suspected compromised blood flow in the tissue
• Patients with a history of vascular issues
• Ensuring the viability of transferred or reconstructed tissues

Preparation

• Fasting: Typically not required.
• Medication Adjustments: Inform your doctor of all medications. Some may need adjustment.
• Pre-Procedure Tests: Blood tests and imaging studies may be done to assess overall health.

Procedure Description

1. IV Placement: An intravenous (IV) line is inserted into a vein in the arm.
2. Dye Injection: The fluorescein dye is slowly injected into the IV.
3. Imaging: As the dye circulates, special cameras or devices may be used to visualize and capture the flow of the dye through the tissue.
4. Assessment: Doctors analyze the images to evaluate the blood flow in the flap or graft.
   • Tools/Equipment: IV catheter, fluorescein dye, imaging devices (such as cameras or Dopplers).
   • Anesthesia/Sedation: Not typically required; the procedure is usually well-tolerated without sedation.

Duration

The entire procedure generally takes between 15 to 30 minutes.

Setting

This procedure can be performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Surgeon or specialized physician
• Nursing staff
• Radiology or imaging technicians

Risks and Complications

• Common Risks: Mild allergic reactions to the dye, temporary yellowish discoloration of the skin and urine.
• Rare Risks: Severe allergic reactions (anaphylaxis), injection site infection, or inflammation.

Benefits

• Expected Benefits: Accurate assessment of blood flow in the flap or graft.
• Timing of Benefits: Immediate visualization and evaluation during the procedure.

Recovery

• Post-Procedure Care: No specific care required. Patients can typically resume normal activities immediately.
• Recovery Time: Immediate.
• Restrictions: No dietary or activity restrictions are typically necessary.
• Follow-Up: As determined by the treating physician.

Alternatives

• Other Options: Doppler ultrasound, angiography, tissue perfusion monitors.
• Pros and Cons of Alternatives: Doppler ultrasound is non-invasive but may be less precise. Angiography offers detailed images but involves more complex preparation and potential risks.

Patient Experience

• During the Procedure: You might feel a brief sting from the IV placement. The dye injection may cause a sensation of warmth.
• After the Procedure: You might notice a slight yellow discoloration of your skin and urine, which is temporary.
• Pain Management: Generally, no pain management is needed; the procedure is minimally uncomfortable.

This detailed markdown guide outlines the key aspects of the intravenous injection of an agent for testing vascular flow in flaps or grafts, providing valuable information for patients and healthcare providers.