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Venous thrombosis imaging, venogram; bilateral

CPT4 code

Name of the Procedure:

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


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).


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.


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.


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.


The procedure typically takes about 30 to 60 minutes.


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


  • 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.


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.


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.


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.

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