Venography, renal, bilateral, selective, radiological supervision and interpretation
CPT4 code
Name of the Procedure:
Venography, Renal, Bilateral, Selective, Radiological Supervision and Interpretation
Summary
Venography is an imaging procedure that uses X-rays to visualize veins. In this context, it focuses on the veins draining the kidneys on both sides (bilateral). Selective venography specifically targets certain veins for more detailed examination. The procedure requires radiological expertise for accurate supervision and interpretation of the images.
Purpose
Venography helps diagnose conditions related to the renal veins, such as blockages, abnormalities, or blood clots. The goal is to obtain a clear image of the renal veins to guide diagnosis and treatment, ensuring proper kidney function.
Indications
The procedure is indicated for patients experiencing symptoms like unexplained kidney pain, blood in the urine, or suspected renal vein thrombosis. It is also useful for evaluating hypertension related to renal vein abnormalities.
Preparation
Patients may need to fast for several hours before the procedure. They should inform their healthcare provider about all medications they are taking, as some may need adjustment. Pre-procedure assessments could include blood tests and kidney function tests.
Procedure Description
- The patient is positioned on an X-ray table, and an intravenous (IV) line is placed.
- Local anesthesia is administered at the catheter insertion site.
- A catheter is inserted into a vein, usually in the groin or arm, and guided towards the renal veins.
- Contrast dye is injected through the catheter to highlight the veins on X-ray images.
- The radiologist takes several X-rays while guiding the catheter to obtain clear and detailed images.
- Once sufficient images are captured, the catheter is removed, and pressure is applied to the insertion site to prevent bleeding.
Duration
The procedure typically takes 60 to 90 minutes.
Setting
Venography is performed in a hospital or an outpatient clinic equipped with an interventional radiology suite.
Personnel
The procedure involves an interventional radiologist, radiology technologists, and nurses. An anesthesiologist may be present if sedation is required.
Risks and Complications
Risks include allergic reactions to the contrast dye, infection, bleeding at the catheter insertion site, and, rarely, kidney damage. Complications are managed by the medical team and can include medications for allergic reactions or interventions to stop bleeding.
Benefits
The primary benefit is accurate diagnosis, guiding appropriate treatment plans for renal vein conditions. Improved kidney function and relief of symptoms are expected outcomes, usually realized shortly after the procedure.
Recovery
Patients may need to lie flat for a few hours post-procedure to minimize bleeding. They should avoid strenuous activities for 24-48 hours. Follow-up appointments may be scheduled to monitor recovery and discuss results.
Alternatives
Alternatives include Doppler ultrasound and CT or MR angiography. Each has its own advantages and disadvantages, such as different levels of invasiveness, detail of images, and patient comfort.
Patient Experience
Patients might feel slight pressure or discomfort during catheter insertion. Post-procedure, they may experience mild soreness at the insertion site. Pain is typically minimal and managed with over-the-counter pain relievers.
Comfort measures, such as a warm blanket and reassurances from the healthcare team, help ensure a more positive experience.