Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing
CPT4 code
Name of the Procedure:
Computed Tomographic Angiography (CTA) of the Upper Extremity with Contrast Material
Summary
Computed Tomographic Angiography (CTA) of the upper extremity is a diagnostic imaging procedure that uses computed tomography (CT) scans and a special dye (contrast material) to visualize the blood vessels in the arms. This helps in detecting blockages, aneurysms, or other vascular conditions.
Purpose
The primary aim of CTA of the upper extremity is to diagnose and evaluate blood vessel conditions in the arms. It helps in identifying problems such as arterial blockages, aneurysms, or other vascular abnormalities. The expected outcome is a clear image of the blood vessels, aiding in accurate diagnosis and appropriate treatment planning.
Indications
- Symptoms of poor circulation in the arms (e.g., pain, numbness, or weakness).
- Suspected arterial blockages or aneurysms.
- Assessment before or after vascular surgery.
- Trauma to upper extremity arteries.
- Monitoring known vascular conditions.
Preparation
- Patients may be asked to fast for several hours prior to the procedure.
- Discontinue certain medications as advised by the healthcare provider.
- Inform the healthcare team of any allergies, particularly to iodine or contrast material.
- Complete pre-procedure diagnostic tests such as blood work.
Procedure Description
- The patient will lie on the CT scan table.
- An intravenous (IV) line is placed to administer the contrast material.
- Initial noncontrast images are taken to provide a baseline.
- Contrast material is injected through the IV, which highlights the blood vessels.
- The CT scanner then takes detailed, cross-sectional images of the upper extremity.
- Postprocessing, including the reconstruction of images, provides a detailed view of the arteries.
Tools used include the CT scanner and contrast material. No anesthesia is typically required, though some patients might receive a mild sedative.
Duration
The entire process usually takes about 30-60 minutes.
Setting
CTA of the upper extremity is typically performed in a hospital or an outpatient radiology clinic.
Personnel
- Radiologist
- Radiologic technologist
- Nursing staff for IV placement and patient monitoring
Risks and Complications
- Rare allergic reactions to the contrast material.
- Risk of kidney damage in patients with pre-existing kidney conditions.
- Minor discomfort from the IV placement; potential bruising at the injection site.
Benefits
- Non-invasive and highly accurate visualization of blood vessels.
- Swift diagnosis leading to timely treatment.
- Clear and detailed images assist in precise medical decision-making.
Recovery
- Most patients can resume normal activities immediately after the procedure.
- Increase fluid intake to help flush the contrast material from the body.
- Follow-up appointments if abnormalities are detected.
Alternatives
- Magnetic Resonance Angiography (MRA)
- Doppler Ultrasound
- Conventional Angiography Each alternative has its pros and cons, such as varying levels of invasiveness, accuracy, and contraindications based on the patient's condition.
Patient Experience
During the procedure, patients might feel a warm sensation as the contrast material is injected. Post-procedure, minimal discomfort is typically experienced, mainly localized to the IV insertion site. Pain management generally involves over-the-counter pain relievers, if necessary, and measures to maintain comfort during and after the scan.