# Proceudre percutaneous transvenous retrieval of embolized guidewire



## indirakumaris (May 8, 2012)

Hi 
Please help out to find the CPT for this procedure mentioned below

HISTORY  The patient was undergoing permanent transvenous dual chamber pacemaker implantation via the left subclavian vein  The guidewire migrated distally and embolized into the vena cava with the J tip in the common femoral vein and proximal tip in the SVC

PROCEUDRE PERCUTANEOUS TRANSVENOUS RETRIEVAL OF EMBOLIZED GUIDEWIRE

PROCEDURE DONE  Pt was brought from the OR to the cath lab having received sedation during pacer implantation in the OR  The right groin was steriley prepped and draped and locally anesthetized wtih 1percent lidocaine  the embolized wire was localized under fluroscopy  According to teh modified seldinger technique a 6 French sheath was placed in the right common femoral vein  The J tip of the wire was located in the femoral vein below the level of the femoral trocanter distal to below the site of femoral venous entry  A 10 mm EV3 Amplatz Gooseneck Snare was advanced to the SVC and over the straight end of the wire The snare in the open configuration was moved toward the proximal end of the wire but in the process without significant or intentional traction the newly implanted atrial lead was dislodged from the right atrial appendage into the right ventricle patient was not pacer dependent  The snare was moved back cephalad to the end of the wire where it was engaged and the wire moved upstream into the innominate vein to move the distal J tip back upstream to allow acess via the sheath  The snare was disengaged and brought back to the femoral vein  The sheath was then withdrawn to below the J tip of the repositioned wire  The J tip was captured with the snare and successfully withdrawn through the sheath  The femoral venous sheath was then removed and hemostasis acheived by manual compression.

Thanks a lot
Indira


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## Dr.T.Sugathan (May 8, 2012)

37215 

Dr.T.Sugathan CPC-H


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## dpeoples (May 8, 2012)

indirakumaris said:


> hi
> please help out to find the cpt for this procedure mentioned below
> 
> history  the patient was undergoing permanent transvenous dual chamber pacemaker implantation via the left subclavian vein  the guidewire migrated distally and embolized into the vena cava with the j tip in the common femoral vein and proximal tip in the svc
> ...



37203/75961
36010

hth


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