Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast injection(s), image postprocessing, permanent recording of
CPT4 code
Name of the Procedure:
Selective Catheter Placement (First-Order), Main Renal Artery and Accessory Renal Arteries for Renal Angiography
Summary
Selective catheter placement for renal angiography involves placing a catheter in the main renal artery and any accessory renal arteries. This allows for detailed imaging of the renal blood vessels using fluoroscopy and contrast injections. The procedure helps to diagnose and manage conditions affecting the kidneys' blood supply.
Purpose
The procedure is used to diagnose and treat issues related to the kidneys' blood vessels, such as blockages, aneurysms, or abnormal blood flow. It aims to provide clear images of the renal arteries, which can guide further treatment or surgical interventions.
Indications
This procedure is indicated for patients experiencing unexplained high blood pressure, suspected renal artery stenosis, kidney tumors, or other vascular abnormalities in the kidneys. It is also used for patients with kidney transplants to assess blood flow.
Preparation
Patients may be instructed to fast for several hours before the procedure and adjust certain medications as advised by their healthcare provider. Pre-procedure assessments may include blood tests and medical imaging to ensure the patient is a suitable candidate for the procedure.
Procedure Description
- Arterial Puncture: The procedure begins with an arterial puncture, typically in the groin area.
- Catheter Placement: A catheter is carefully guided through the arterial system to the main renal artery and any accessory renal arteries.
- Fluoroscopy: Continuous X-ray imaging (fluoroscopy) is used to visualize the catheter's placement.
- Contrast Injection: A contrast dye is injected through the catheter to highlight the blood vessels.
- Image Postprocessing and Recording: Images are captured, processed, and permanently recorded for further analysis.
Tools and equipment include a catheter, contrast dye, and fluoroscopy machine. Local anesthesia is commonly used to numb the puncture site, and sedation may be provided for patient comfort.
Duration
The procedure typically takes about 1-2 hours, depending on the complexity.
Setting
The procedure is usually performed in a hospital or specialized medical center with imaging facilities.
Personnel
The healthcare team includes an interventional radiologist or vascular surgeon, radiologic technologists, nurses, and possibly an anesthesiologist.
Risks and Complications
Risks include bleeding, infection, allergic reactions to the contrast dye, artery damage, and kidney damage. Rare complications may involve blood clots or adverse reactions to medications.
Benefits
The primary benefit is obtaining detailed images of the renal arteries, which can lead to accurate diagnosis and effective treatment planning. Patients may see improvements in symptoms related to kidney conditions soon after the procedure.
Recovery
Post-procedure care includes monitoring the puncture site for bleeding and ensuring stable vital signs. Patients are typically advised to rest and avoid strenuous activities for a few days. Follow-up appointments may be scheduled to review results and plan further treatment if necessary.
Alternatives
Alternative options may include non-invasive imaging techniques like CT or MR angiography, as well as medical management for symptoms. Each alternative has its pros and cons, with selective catheter placement providing the most detailed and direct visualization of the renal arteries.
Patient Experience
Patients may experience slight discomfort during the catheter insertion and a warm sensation when the contrast dye is injected. Pain management strategies and sedation help to ensure the patient's comfort throughout the procedure. Post-procedure, some soreness at the puncture site is normal, and any significant discomfort should be reported to the healthcare team immediately.