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
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:
- The patient lies on an X-ray table.
- A local anesthetic is applied to numb the area where the needle will be inserted.
- A catheter is inserted into a vein in the foot or leg.
- Contrast dye is injected through the catheter.
- X-ray images are taken to capture the flow of dye and visualize the veins.
- 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.