Stenosis in Left external iliac and Left common Iliac
The patient brought in to the Operating Room
table, was prepped and draped in a sterile fashion with chlorhexidine solution.
The right common femoral artery was accessed by fluoroscopic guidance and using
an 18-gauge needle, was selected with a 0.018 micro wire, was placed into the
mid abdominal aorta. A micro sheath was then placed and exchanged to a 5-French
sheath. After placing a Glidewire, a VCF catheter was then placed in the mid
abdominal aorta and abdominal aortogram was performed demonstrating significant
stenosis of the left common iliac artery and left external iliac artery with a
left SFA occlusion of 10 cm with significant collaterals and reconstitution of
the above-knee popliteal artery and with anterior tibial and posterior tibial
artery distal runoff. Attempt to pass the SFA occlusion after placing a
6-French 45 cm sheath into the SFA after selecting the left lower extremity was
attempted and was unsuccessful due to an oblique occlusion and unable to pass.
At this time, the wire and sheath were then placed into the abdominal aorta and
an angioplasty of the left external iliac artery with a 6 x 40 balloon and the
left common iliac was angioplastied with a 7 x 20 balloon with minimal residual
stenosis. After the angioplasty of the left common iliac and left external
iliac artery, the abdominal aortogram demonstrated minimal residual stenosis and
a palpable left femoral pulse. Due to significant improvement of inflow, all
wires and sheath were removed and a closure device was performed of the right
common femoral artery with a 6-French Mynx closure device. The patient
tolerated well the procedure and no complications during procedure.
37220 or 37220,37222
The patient brought in to the Operating Room
table, was prepped and draped in a sterile fashion with chlorhexidine solution.
The right common femoral artery was accessed by fluoroscopic guidance and using
an 18-gauge needle, was selected with a 0.018 micro wire, was placed into the
mid abdominal aorta. A micro sheath was then placed and exchanged to a 5-French
sheath. After placing a Glidewire, a VCF catheter was then placed in the mid
abdominal aorta and abdominal aortogram was performed demonstrating significant
stenosis of the left common iliac artery and left external iliac artery with a
left SFA occlusion of 10 cm with significant collaterals and reconstitution of
the above-knee popliteal artery and with anterior tibial and posterior tibial
artery distal runoff. Attempt to pass the SFA occlusion after placing a
6-French 45 cm sheath into the SFA after selecting the left lower extremity was
attempted and was unsuccessful due to an oblique occlusion and unable to pass.
At this time, the wire and sheath were then placed into the abdominal aorta and
an angioplasty of the left external iliac artery with a 6 x 40 balloon and the
left common iliac was angioplastied with a 7 x 20 balloon with minimal residual
stenosis. After the angioplasty of the left common iliac and left external
iliac artery, the abdominal aortogram demonstrated minimal residual stenosis and
a palpable left femoral pulse. Due to significant improvement of inflow, all
wires and sheath were removed and a closure device was performed of the right
common femoral artery with a 6-French Mynx closure device. The patient
tolerated well the procedure and no complications during procedure.
37220 or 37220,37222