Name of the Procedure:

Venous Thrombosis Imaging, Venogram; Bilateral
Common Name(s): Bilateral Venogram
Technical/Medical Term: Bilateral Venography

Summary

A bilateral venogram is a diagnostic imaging procedure used to visualize the veins in both legs. It involves injecting a contrast dye into the veins and taking X-ray images to detect the presence of blood clots (venous thrombosis).

Purpose

The medical condition or problem it addresses:

To identify and evaluate blood clots in the veins of the legs.

The goals or expected outcomes of the procedure:

To confirm or rule out the presence of venous thrombosis, guide further treatment, and prevent complications such as pulmonary embolism.

Indications

Specific symptoms or conditions that warrant the procedure:

• Swelling, pain, or redness in both legs.
• Unexplained leg discomfort.
• Suspicion of blood clots due to medical history or physical examination.

Patient criteria or factors that make the procedure appropriate:

• Patients with risk factors for deep vein thrombosis (DVT), such as recent surgery, immobility, or history of clotting disorders.

Preparation

Pre-procedure instructions for the patient:

• Fasting may be required for a few hours prior to the procedure.
• Inform the doctor of any allergies, especially to contrast dye or iodine.
• Adjustments to current medications, as advised by the healthcare provider.

Any diagnostic tests or assessments required beforehand:

• Blood tests to check kidney function and clotting status.
• Medical history review and physical examination.

Procedure Description

Step-by-step explanation:

1. The patient lies on an X-ray table.
2. A local anesthetic is applied to numb the area where the needle will be inserted.
3. A catheter is inserted into a vein in the foot or leg.
4. Contrast dye is injected through the catheter.
5. X-ray images are taken to capture the flow of dye and visualize the veins.
6. The catheter is removed, and a bandage is applied to the insertion site.

Tools, equipment, or technology used:

• X-ray machine
• Catheter
• Contrast dye
• Local anesthetic

Anesthesia or sedation details, if applicable:

Local anesthetic to numb the catheter insertion area.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

Performed in a hospital radiology department or an outpatient imaging center.

Personnel

• Radiologist or vascular specialist
• Radiologic technologist
• Nurse

Risks and Complications

Common and rare risks associated with the procedure:

• Allergic reaction to contrast dye
• Infection at the injection site
• Bruising or bleeding
• Rare risk of kidney damage from the contrast dye

Possible complications and their management:

• If any complications occur, such as an allergic reaction, they are managed immediately with appropriate medications or interventions.

Benefits

Expected benefits:

• Accurate diagnosis of venous thrombosis.
• Preventive information for further complications like pulmonary embolism.
• Guidance for appropriate treatment plan.

How soon they might be realized:

The benefits are immediate as the imaging results are reviewed shortly after the procedure.

Recovery

Post-procedure care and instructions:

• Monitor the injection site for signs of infection or excessive bleeding.
• Resume normal activities as instructed by the healthcare provider.
• Stay hydrated to help flush out the contrast dye from the body.

Expected recovery time and any restrictions or follow-up appointments:

• Recovery is generally quick, with most patients resuming normal activities within 24 hours.
• Follow-up appointments as needed to discuss imaging results and further treatment.

Alternatives

Other treatment options available:

• Doppler ultrasound
• Magnetic Resonance Venography (MRV)
• Computed Tomography Venography (CTV)

Pros and cons of alternatives compared to the described procedure:

• Doppler ultrasound: Less invasive, no contrast dye needed; however, it may be less detailed.
• MRV and CTV: Provide detailed images without X-rays; however, they may be more expensive and less readily available.

Patient Experience

What the patient might feel or experience during and after the procedure:

• Mild discomfort or a stinging sensation during the catheter insertion and dye injection.
• Temporary feeling of warmth throughout the body when the contrast dye is injected.
• Mild soreness or bruising at the injection site after the procedure.

Pain management and comfort measures:

• Local anesthetic to minimize pain during the procedure.
• Post-procedure pain can generally be managed with over-the-counter pain relievers.