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Computed tomographic angiography, lower 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 Lower Extremity with Contrast Material, Including Noncontrast Images and Image Postprocessing

Summary

Computed Tomographic Angiography (CTA) of the lower extremity is an advanced imaging technique used to visualize the blood vessels in your legs. It involves the injection of a contrast dye to enhance the clarity of images taken by a CT scanner.

Purpose

The procedure helps diagnose vascular conditions such as blockages, aneurysms, or other abnormalities in the blood vessels of the legs. The goal is to obtain detailed images that assist in planning appropriate treatments.

Indications

  • Symptoms like leg pain, swelling, or ulcers.
  • Suspected vascular diseases such as peripheral artery disease (PAD).
  • Evaluation after vascular surgery or interventions.
  • Planning for interventions like stents or bypass surgery.

Preparation

  • Patients may be instructed to fast for a few hours before the procedure.
  • Inform your doctor of any allergies, particularly to contrast dyes.
  • Blood tests may be required to assess kidney function before administering the contrast material.
  • If you are pregnant or have chronic kidney disease, inform your healthcare provider.

Procedure Description

  1. The patient lies on a CT scanner table.
  2. An IV line is inserted into a vein in the arm to administer the contrast dye.
  3. Initial noncontrast images are taken.
  4. The contrast dye is injected, and a series of CT scans are rapidly taken of the lower extremities.
  5. Image postprocessing is performed to create detailed 3D images of the blood vessels.

Tools and Technology Used:

  • CT Scanner
  • IV Contrast Material
  • Image processing software

Anesthesia or Sedation:

  • Usually not required, though a mild sedative may be given if the patient is anxious.

Duration

The entire procedure typically takes about 30 to 60 minutes.

Setting

CT angiography is usually performed in a hospital radiology department or an outpatient imaging center.

Personnel

  • Radiologist (primarily responsible for procedure and interpretation)
  • Radiologic technologist
  • Nurse (for IV line placement and patient monitoring)

Risks and Complications

  • Allergic reactions to contrast dye (ranging from mild to severe)
  • Kidney function impact due to contrast material
  • Radiation exposure, though minimized with modern equipment

Benefits

  • Non-invasive and relatively quick
  • High accuracy in detecting vascular abnormalities
  • Assists in planning precise medical or surgical interventions

Recovery

  • Patients can usually return to their normal activities immediately.
  • Drink plenty of fluids to help flush out the contrast dye.
  • Some patients may experience a warm sensation or metallic taste during the injection of the contrast material.

Alternatives

  • Magnetic Resonance Angiography (MRA)
  • Doppler Ultrasound
  • Conventional angiography

Each alternative has its own pros and cons regarding image clarity, invasiveness, and suitability depending on the patient's specific condition.

Patient Experience

Patients may feel slight discomfort when the IV line is inserted and a warm, flushing sensation during the contrast injection. Some anxiety due to the confined space of the CT scanner is common. Pain management is usually not necessary as the procedure is non-invasive.

Medical Policies and Guidelines for Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing

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