Background Information:

What are the other Names for the Procedure?

• Ascending Phlebography
• Phlebography
• Venogram

What is Venography radiology procedure? (General Explanation)

• A Venography is performed to determine the condition of the veins
• It involves injecting contrast material into a vein and visualizing it using X-ray technology

What part of the Body does the Procedure involve?

Depending upon the vein being accessed, various parts of the body could be involved during the Venography procedure.

Why is the Venography radiology procedure Performed?

A Venography is performed for following reasons:

• To visualize veins, for the treatment of diseased veins
• To determine the condition of veins
• To diagnose a blood clot in the vein
• To place IV or catheter in the vein
• To diagnose varicose veins and assess their condition before surgery

What is the Equipment used? (Description of Equipment)

Fluoroscopy is used during the Venography procedure.

• Fluoroscopy uses X-ray technology
• It consists of an examination table, an X-ray tube, and a television-like monitor
• Fluoroscopy converts X-rays into video images that can be seen in real-time on the television monitor

What are the Recent Advances in the Procedure?

There have been no recent advances in the Venography procedure.

What is the Cost of performing the Venography radiology procedure?

The cost of Venography procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding Venography procedure and what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.ncbi.nlm.nih.gov/pubmed/25725216 (assessed on 3/9/15)

http://www.ncbi.nlm.nih.gov/pubmed/25724223 (assessed on 3/9/15)

Prior to Venography radiology procedure:

How does the Venography radiology procedure work?

• X-rays use radio waves that pass through the patient’s body. Images are recorded on a plate on the other side of the patient’s body
• Various parts of the body absorb different amounts of radiation, which show up differently in shades of white, grey, or black on the plate
• Since veins are not seen on X-ray images, a contrast material is injected into the vein to visualize them during a Venography

How is the Venography radiology procedure Performed?

Venography is performed in the following manner:

• The patient is positioned on the examination table in a supine position. In certain procedures, the patient may be required to be a in standing position
• An IV line is inserted into the patient’s arm vein
• A contrast material is injected through the IV line. As the contrast material goes through thevein, fluoroscopy is used to visualize the veins
• Patients may be asked to change their position, to take the pictures from different angles

Where is the Procedure Performed?

A Venography procedure is performed as an outpatient procedure, at a hospital.

Who Performs the Procedure?

An interventional radiologist performs the Venography procedure.

How long will the Procedure take?

• A Venography procedure takes about 30 minutes to complete
• It may take longer depending upon the complexity of the procedure and health of the patient

Who interprets the Result?

An interventional radiologist interprets the results of the Venography procedure.

What Preparations are needed, prior to the Procedure?

The following preparations are needed prior to the Venography procedure:

• Patients should inform their physicians about their medical conditions, medications, and any over the counter medications or herbal supplements that they are taking
• Patient should inform their physician if they are allergic to any medications especially to local anesthetic medications and contrast material
• Patient may be asked to stop taking any blood thinner medications, such as NSAIDs, aspirin, heparin, and warfarin, to avoid any excessive bleeding during the procedure
• Patients may be asked not to eat or drink several hours before the procedure
• Women should inform their physician if they are pregnant or if there is a chance of them being pregnant

What is the Consent Process before the Procedure?

A physician will request your consent for the Venography procedure using an Informed Consent Form.

Consent for the Venography Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of Venography procedure:

• Venography is a minimally invasive procedure and is extremely useful in diagnosing conditions that involve the veins
• Since fluoroscopy is used to during the procedure, it decreases the risk of damaging the blood vessel
• Venography is also useful in detecting a blood clot in the vein

Following are the risks of Venography procedure:

• The procedure may cause deep vein thrombosis, where a blood clot is formed in the vein. Although, this is a very rare condition
• Contrast material used during the procedure may cause severe allergic reactions in certain patient populations
• Contrast material used during the procedure may damage the kidneys. Patients with chronic kidney disease or impaired kidney function should be evaluated carefully before using any contrast material
• If excessive radiation is used during the procedure, it may increase the risk of cancer in the future
• There is a chance of damaging or bruising the blood vessel during the venogram

What are the Limitations of the Venography radiology procedure?

• Ultrasounds may be used instead of X-ray fluoroscopy during the Venography procedure, as it does not involve exposing patients to radiation; also it has fewer side effects
• If the patient is unable to stay still during the procedure, it can affect how the contrast material flows and this may cause disrupt the results of Venography

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

• What is a Venography procedure?
• Why is this procedure necessary? How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place during recovery?
• What are the possible side effects from the procedure? How can I minimize these side effects?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required after the procedure?
• Is there any medication that needs to be taken for life after the procedure?
• What are the costs involved?

During the Venography radiology procedure:

What is to be expected during the Venography radiology procedure?

• Patients may feel a slight pinprick when the IV line is inserted into the patient’s vein and local anesthetic is injected during Venography
• Patient may feel a warm sensation when the contrast material is injected
• Patient may experience metallic taste in their mouth
• Patient may feel that their arm or leg is getting numb during the procedure. This feeling goes away after a few minutes
• Patient will be told to hold their breath and stay still, while the images are being taken, in order to get a better quality of images
• After the procedure is complete, patients are asked to wait in the recovery room while the technologist determines if all the images are taken

What kind of Anesthesia is given, during the Procedure?

Anesthesia is rarely used during the Venography procedure.

How much Blood will you lose, during the Procedure?

Since Venography is a minimally invasive procedure, the blood loss involved during the procedure is minimal.

What are the possible Risks and Complications during the Venography radiology Procedure?

• Rarely, Venography may cause deep vein thrombosis where blood clot is formed in the vein
• Sometimes, the contrast material used during the procedure may cause severe allergic reactions
• Contrast material used during the procedure may damage the kidneys. Individuals with chronic kidney disease or impaired kidney function should be given careful consideration while using any contrast material
• Excessive radiation used during the procedure can increase one’s risk of cancer
• Venography may sometimes damage or bruise the blood vessel

What Post-Operative Care is needed at the Healthcare Facility after the Venography radiology procedure?

No specific post-operative care is needed at the healthcare facility after the Venography procedure.

After the Venography radiology procedure:

What is to be expected after the Venography radiology procedure?

• Patients are given IV fluids during and after the Venography procedure to flush the contrast material from the veins
• Pressure is applied on the catheter insertion site to prevent bleeding (if a catheter was inserted)
• In certain cases, patient may be admitted to the hospital for observation

When do you need to call your Physician?

Patients may need to call their physician in following situations after a Venography procedure:

• If any redness, tenderness, swelling, warmth at the needle or catheter insertion site is observed
• If the patient develops a high fever

What Post-Operative Care is needed at Home after the Venography radiology procedure?

• Patients are asked to drink plenty of fluids after the Venography procedure (the next day) to flush all contrast material from the body
• No other postoperative care is needed at home

How long does it normally take to fully recover, from the Procedure?

• Patient may resume their normal activities immediately after the Venography procedure
• However, lifting of any heavy objects should be avoided for 1-2 days hours after the procedure
• Further instructions and recommendations may be given by the physician/healthcare provider

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The Venography procedure does not involve the removal of any body tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the Venography procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Venography radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, where the procedure is performed
• Healthcare providers, physicians, and radiologists, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Venography procedure is performed.