An angiography is a procedure through which images of the blood vessels of the human body are taken by using techniques such as ultrasound and MRI, without any ionizing radiation. The pictures of the arteries and veins produced are known as an angiogram. Peripheral angiography is one of the many types of angiography techniques. Also known as extremity angiography, peripheral angiography is conducted with the aim to evaluate various peripheral vascular diseases. It is used to examine the vascular structures in the arms, hand, legs and feet. It is often recommended in cases where the patient experiences leg cramps or leg claudication.
Coronary angiography and non-coronary angiography are the two basic types of angiography and peripheral angiography comes under the category of non-coronary angiography. The two types of angiography are different in certain key aspects. The image intensifier which is used in the peripheral angiography is of a diameter of 14 cm to 16 cm as compared to the 9 cm ones used in a coronary angiography. This larger diameter helps to view the lower extremities and aorta in a bigger imaging window. Secondly, the imaging technique implemented in the peripheral angiography procedure is digital subtraction angiography. This technique is more efficient because the radiation exposure is significantly greater. Thirdly, the road mapping technique used in the peripheral angiography helps to visualize the blood vessels clearly without the interference of any surrounding tissues or bones.
Different types of information can be extracted and examined using the peripheral angiography procedure. It can be used for measuring the diameter of the blood vessels, to analyze the flow of blood using videodensitometric methods, or for any other hemodynamic measurements. In the process, the X-ray imaging system and the examination zone are shifted to relative positions, and a number of images in different positions are captured. Two types of images are recorded, namely, the mask image and the contrast image. In the next stage, the images are subtracted from each other.
After the subtraction phase of the peripheral angiography procedure is over, the angiographers get the detailed image of only the desired vascular system. The other superposed structures such as the bones and tissues are eliminated from the images. The advantage of using the unique subtraction technique in the peripheral angiography is that it is possible to get high contrast images even by using medium concentration of low contrast. However, one disadvantage of this method is that geometrical discrepancies may occur between the mask image and the contrast image, in case a patient moves during the procedure.
During the procedure, all aspects of the angiogram studies are documented in an accurate manner. The peripheral angiography CPT code is very important as it is implemented in the documentation, coding and the billing process. The five digit CPT code is authenticated by the American Medical Association and is used to communicate the health care procedure in a more effective way. The codes are also used by the health insurance companies so as to reimburse the patients with the appropriate amount of money, as per the diagnostic procedures undertaken. There are different codes for the different target areas and different purposes of peripheral angiography.
With regard to complications of the procedure, studies show that the overall risk of any serious medical complications in peripheral angiography is about 3.5 %. According to a research report published in the Annals of the Royal College of Surgeons of England, there is a low risk of any surgical or medical complications associated with the peripheral angiography procedure. Some of the complications that may arise are hematoma, injury to surrounding nerves and damage to the blood vessels.
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