Injection procedure for extremity venography (including introduction of needle or intracatheter)
CPT4 code
Name of the Procedure:
Injection Procedure for Extremity Venography (Venous Angiography, Venous X-Ray, Extremity Phlebography)
Summary
In this minimally invasive procedure, a doctor uses a needle or catheter to inject a special dye into the veins of your arm or leg. This dye makes your veins visible on an X-ray, allowing the doctor to see any blockages or abnormalities.
Purpose
The procedure is used to diagnose conditions affecting the veins in your extremities, such as blood clots (deep vein thrombosis), blockages, or abnormal vein structures. The goal is to obtain clear images of the veins to guide treatment decisions.
Indications
- Symptoms suggesting blood clots, such as swelling, pain, or redness in the limb
- Chronic venous insufficiency
- Varicose veins
- Unexplained leg pain or swelling
- Evaluation before venous surgery
- Venous malformations or abnormalities
Preparation
- Fasting for a specific period based on your doctor's recommendation
- Adjustment of certain medications (e.g., blood thinners)
- Blood tests or allergy tests to ensure safe use of the contrast dye
Procedure Description
- The patient is positioned comfortably on a table.
- The injection site is cleaned and sterilized.
- A local anesthetic is applied to numb the area.
- A needle or intracatheter is inserted into a vein.
- A contrast dye is injected, which will spread through the venous system.
- X-rays or fluoroscopy images are taken as the dye travels through the veins.
- The needle or catheter is removed after imaging is complete.
- The injection site is bandaged.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
The procedure is usually performed in a hospital radiology department, outpatient clinic, or specialized diagnostic center.
Personnel
- Radiologist (a specialist in imaging)
- Radiology technician
- Nursing staff
- Anesthesiologist (if sedation is required)
Risks and Complications
- Rare allergic reactions to the contrast dye
- Infection at the injection site
- Vein damage or irritation
- Minor bleeding or bruising
- Blood clot formation
- Kidney problems in patients with pre-existing kidney conditions
Benefits
- Accurate diagnosis of venous conditions
- Helps guide appropriate treatment plans
- Non-surgical and generally quick recovery
- Provides detailed imaging of the venous structure
Recovery
- Monitor the injection site for signs of infection
- Follow specific post-procedure instructions regarding activity level
- Possible mild discomfort or bruising at the injection site
- Most patients can resume normal activities within a day
- Follow-up appointment to discuss results and any additional treatment
Alternatives
- Doppler ultrasound for vein imaging (less invasive but may not be as detailed)
- Magnetic Resonance Venography (MRV)
- CT Venography (CTV)
- Pros: These alternatives reduce or eliminate the need for contrast dye
- Cons: May not provide as detailed an image of the venous system, or may be less accessible
Patient Experience
During the procedure, you may feel a slight pinch when the needle is inserted and a warm sensation as the dye is injected. Post-procedure, you might experience mild discomfort or bruising at the injection site. Pain is generally minimal and can be managed with over-the-counter pain relievers if needed. Follow the care instructions provided by your healthcare team to ensure proper recovery.