Name of the Procedure:

Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (List separately in addition to code for primary procedure)

Summary

Selective angiography is a medical imaging technique used to visualize blood vessels. During the procedure, each additional vessel studied after the initial examination is carefully examined using radiological supervision and interpretation to ensure detailed and accurate results.

Purpose

This procedure is used to diagnose and evaluate conditions involving the blood vessels, such as blockages, malformations, aneurysms, or other vascular issues. The goal is to obtain a clear and detailed image of the blood vessels to aid in the planning of subsequent treatments or interventions.

Indications

• Symptoms of vascular disease (e.g., pain, swelling, or weakness in limbs)
• Suspected blockages or narrowing in arteries or veins
• Aneurysms or other vascular abnormalities
• Pre-surgical planning and evaluation
• Follow-up on previously identified vascular conditions

Preparation

• Fasting for several hours before the procedure may be required
• Adjustments to medications (e.g., blood thinners) as advised by the physician
• Pre-procedure lab tests and imaging studies to assess kidney function and overall health

Procedure Description

1. The patient is positioned on an X-ray table, and an intravenous (IV) line may be inserted.
2. The area where the catheter will be inserted (often the groin or arm) is cleaned and numbed with a local anesthetic.
3. A catheter is threaded through a blood vessel to the area of interest while guided by fluoroscopy (a type of X-ray imaging).
4. Once the basic examination is completed, additional vessels are selectively studied by injecting contrast dye and capturing detailed images.
5. Radiological supervision and interpretation are done in real-time to ensure all necessary views are obtained.
6. The catheter is then removed, and pressure is applied to the insertion site to prevent bleeding.

Duration

The procedure typically takes 30 minutes to 2 hours, depending on the number of vessels examined and the complexity of the case.

Setting

This procedure is performed in a hospital's radiology department or a specialized outpatient imaging center.

Personnel

• Interventional radiologist or vascular surgeon
• Radiologic technologists
• Nurses
• Anesthesiologist or nurse anesthetist (if sedation is used)

Risks and Complications

• Common risks: Bleeding or bruising at the catheter insertion site, allergic reaction to contrast dye
• Rare risks: Infection, blood vessel damage, kidney damage from contrast dye, stroke or heart attack

Benefits

• Provides precise and detailed images of blood vessels
• Helps in diagnosing vascular conditions accurately
• Guides treatment planning and can improve patient outcomes
• Results are generally available quickly

Recovery

• Patients may need to lie flat for several hours post-procedure to prevent bleeding
• Monitoring of vital signs and the insertion site
• Drinking fluids to help flush out the contrast dye
• Mild soreness at the insertion site may occur
• Most patients can resume normal activities within a day or two

Alternatives

• Non-invasive imaging techniques like CT Angiography (CTA) or Magnetic Resonance Angiography (MRA)
• Ultrasound/Doppler imaging for certain vascular conditions
• Each alternative has its own benefits and limitations; a healthcare provider can discuss the best option based on individual circumstances

Patient Experience

• Mild discomfort during the insertion of the catheter and contrast dye injection
• Sensations of warmth or flushing as the dye is injected
• Post-procedure soreness and restrictions on activities temporarily
• Pain management with over-the-counter pain relievers if needed

Overall, selective angiography is a valuable diagnostic tool for detailed vascular imaging and plays a crucial role in the effective management of vascular conditions.