# Renal Angiogram and Embolization



## birky (Dec 7, 2010)

Another one, any suggestions are helpful. Thank you



SERVICES PROVIDED
1. Selective accessory left renal artery angiogram.
2. Embolization of the accessory left renal artery.
3. Postembolization angiography. 
4. Intravenous moderate sedation.

The procedure was explained in detail to the patient. Potential risks, benefits and alternative therapies were discussed.  All questions were answered and informed consent was obtained.  

The patient's right groin was examined with ultrasound showing patency of the right common femoral artery. Patient's right groin was sterilely scrubbed, prepped and draped in standard fashion.  Local anesthetic was applied using 2% Xylocaine. Using ultrasound guidance and a micropuncture needle, access was gained into the right common femoral artery.  Ultrasound was used to visualize the needle entering into the lumen of the vessel.  The percutaneous access was dilated to accept a 5-French introducer sheath through which a 5-French angled catheter was guided fluoroscopically over a wire into the abdominal aorta. Catheter and wire were used to gain access into the inferior accessory left renal artery and an angiogram was performed. Using a coaxial 3-French through the 5-French catheter, the accessory left renal artery was selectively coil embolized using several microcoils. Postembolization angiogram was performed showing occlusion of the accessory left renal artery. The catheter and sheath were then removed and hemostasis achieved of the right groin using manual compression. 

IMPRESSION
1. ABDOMINAL AORTIC ANEURYSM WITH ACCESSORY LEFT RENAL ARTERY RISING JUST ABOVE THE ORIGIN OF THE ABDOMINAL AORTIC ANEURYSM. 

2. SELECTIVE CATHETERIZATION AND COIL EMBOLIZATION OF THE ACCESSORY LEFT RENAL ARTERY.


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## kbazarte@yahoo.com (Dec 7, 2010)

it sounds from the report that diagnostic studies were previously performed so the codes would be:

37204 embolization 
75894 S & I
36245 cath selection 1st order below the diaphragm


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