72191 Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing

Name of the Procedure:

Computed Tomographic Angiography (CTA) of the Pelvis with Contrast Material(s)

• Also known as Pelvic CTA or CT Angiogram of the Pelvis.

Summary

CTA of the pelvis is a specialized radiological procedure that uses a CT scanner to produce detailed images of the blood vessels in the pelvic area. This test involves the injection of contrast material to enhance the visibility of blood vessels, and often includes accompanying non-contrast images and post-processing for comprehensive assessment.

Purpose

This procedure is used to:

• Diagnose and evaluate conditions affecting the blood vessels in the pelvic region.
• Assess vascular abnormalities, such as aneurysms, blockages, or malformations.
• Guide treatment planning for vascular conditions or surgical interventions.

Indications

• Symptoms like pelvic pain, swelling, or unexplained bleeding.
• Suspected pelvic aneurysms, blood clots, or arterial blockages.
• Pre-surgical planning for procedures involving pelvic blood vessels.
• Monitoring of known vascular conditions or post-surgical outcomes.

Preparation

• Patients may need to fast for 4-6 hours prior to the procedure.
• Inform the healthcare provider of any allergies, particularly to contrast material, and all medications being taken.
• Pre-procedure blood tests may be required to assess kidney function.
• Patients should remove any metal objects or jewelry from the pelvic area.

Procedure Description

1. The patient lies on a scanning table, usually on their back.
2. An intravenous (IV) line is inserted, typically into the arm, to administer the contrast material.
3. Initial non-contrast images may be taken.
4. The contrast material is injected, and the patient may feel a warm sensation.
5. The CT scanner rotates around the patient to capture detailed cross-sectional images of the pelvic blood vessels.
6. Image post-processing is performed to create a comprehensive view of the vascular structures.

Duration

The entire procedure typically takes about 30 to 60 minutes.

Setting

CTA of the pelvis is performed in a radiology or imaging department of a hospital or outpatient clinic.

Personnel

• Radiologist: Specializes in interpreting medical images.
• Radiologic Technologist: Operates the CT scanner and assists with the procedure.
• Nurse: May assist with the IV line and patient preparation.

Risks and Complications

• Allergic reaction to the contrast material (rare but possible).
• Kidney function impairment (especially in patients with pre-existing kidney conditions).
• Exposure to a small amount of ionizing radiation.
• Potential for discomfort during IV insertion or injection.

Benefits

• Provides detailed images of the pelvic blood vessels, aiding in accurate diagnosis and effective treatment planning.
• Non-invasive compared to surgical diagnostic methods.
• Quick recovery with minimal downtime.

Recovery

• Patients can usually return to normal activities immediately after the procedure.
• Drink plenty of fluids to help flush out the contrast material.
• Follow any specific post-procedure instructions given by the healthcare provider.

Alternatives

• Magnetic Resonance Angiography (MRA): Uses magnetic fields instead of radiation and may be appropriate for certain patients.
• Doppler Ultrasound: Uses sound waves to evaluate blood flow but may be less detailed.
• Traditional Angiography: Invasive with the use of a catheter but might be necessary for specific situations.

Patient Experience

• During the procedure, the patient will need to remain still and may be asked to hold their breath for short periods.
• The IV insertion may cause minor discomfort or a brief sting.
• Some patients may experience a warm sensation or metallic taste from the contrast material.
• Most patients experience little to no pain and can resume normal activities shortly after the procedure.