nlbarnes
Expert
Need confirmation or correction of codes please.
After local anesthetic infiltration, ultrasound was
used to percutaneously access the right common femoral artery after
which guidewire and sheath were placed in vessel without difficulty.
At this time, the patient was systemically heparinized with a total of
10000 units of intravenous heparin with final ACT of 297. A stiff
angled Glidewire followed by a marker pigtail catheter were tracked to
the ascending aorta after which an arch angiogram was performed,
revealing the patent origin of the innominate left carotid and left
subclavian arteries. At this time, a 90 cm shuttle sheath was tracked
over the stiff angled Glidewire to the proximal descending thoracic
aorta after which a H1 Headhunter Slip-Cath along with a stiff-angled
Glidewire were used to interrogate and access the origin of left
common carotid artery after which the sheath was tracked into the left
common carotid artery without difficulty. At this time, an isolated
left carotid angiogram was performed as described above. At this
time, the NAV6 embolic protection device was inserted through the
sheath and the lesion was crossed using the guidewire itself which was
placed into the distal ICA. A NAV6 embolic protection device was then
deployed cephalad to the lesion without difficulty. After employment
of the embolic protection device, a 4 mm x 20 mm angioplasty balloon
was used to predilate the carotid stenosis after which a 6 to 8 mm x
40 mm Xact carotid stent was deployed across the area of stenosis
without difficulty. Completion angiogram revealed complete resolution
of stenosis with no residual stenosis present. At this time, the NAV6
embolic protection device capture sheath was inserted and the embolic
protection device was easily captured and removed. Completion
angiogram revealed patent carotid bifurcation with good filling of the
MCA and intracranial branches.
After local anesthetic infiltration, ultrasound was
used to percutaneously access the right common femoral artery after
which guidewire and sheath were placed in vessel without difficulty.
At this time, the patient was systemically heparinized with a total of
10000 units of intravenous heparin with final ACT of 297. A stiff
angled Glidewire followed by a marker pigtail catheter were tracked to
the ascending aorta after which an arch angiogram was performed,
revealing the patent origin of the innominate left carotid and left
subclavian arteries. At this time, a 90 cm shuttle sheath was tracked
over the stiff angled Glidewire to the proximal descending thoracic
aorta after which a H1 Headhunter Slip-Cath along with a stiff-angled
Glidewire were used to interrogate and access the origin of left
common carotid artery after which the sheath was tracked into the left
common carotid artery without difficulty. At this time, an isolated
left carotid angiogram was performed as described above. At this
time, the NAV6 embolic protection device was inserted through the
sheath and the lesion was crossed using the guidewire itself which was
placed into the distal ICA. A NAV6 embolic protection device was then
deployed cephalad to the lesion without difficulty. After employment
of the embolic protection device, a 4 mm x 20 mm angioplasty balloon
was used to predilate the carotid stenosis after which a 6 to 8 mm x
40 mm Xact carotid stent was deployed across the area of stenosis
without difficulty. Completion angiogram revealed complete resolution
of stenosis with no residual stenosis present. At this time, the NAV6
embolic protection device capture sheath was inserted and the embolic
protection device was easily captured and removed. Completion
angiogram revealed patent carotid bifurcation with good filling of the
MCA and intracranial branches.
