calorom2
Networker
Would this be 37221-LT and 37221-RT? Thanks in advance for the help!
PROCEDURE:
Bilateral common iliac stent, bilateral selective angiogram.
COMPLICATIONS:
None.
ESTIMATED BLOOD LOSS:
Less than 5 mL.
INDICATION FOR PROCEDURE:
Lifestyle limiting claudication, recurrent stenting.
DESCRIPTION OF PROCEDURE:
After informed consent, discussion of risks and benefits, a 5-French
sheath was placed in the right common femoral artery under ultrasound
guidance. Angiography was performed using a Contra catheter. The patient
has had 2 bare metal stents in the right common iliac and there are
2 areas of stenosis inside the stent of 90% in both in the proximal
edge and the distal edge. The patient was anticoagulated to a therapeutic
ACT. A 7-French sheath was placed. The artery was stented with a 8.0
x 58 atrium covered stent at 12 atmospheres of pressure to reach a size
of 8.5 with good apposition. We then took selective angiography of
the left. There was a significant lesion in the common femoral, but
there was no gradient across it. On pullback, there was a 60 mm gradient
in the common iliac, selective angiography confirmed 80 to 90% stenosis.
Of note, right internal iliac is totally occluded and is supplied through
sacral artery. The left internal iliac was patent. We decided to do
a non-covered stent. The artery was stented with a cobalt 8.0 x 27
stent at 10 atmospheres of pressure. The stent was post dilated proximally
by a 9.0 __________ x 15. We did lose the internal iliac on the left.
I am hoping that
this collateralizes through that same sacral collateral. The patient
was counseled on symptoms. Further recommendations to follow clinical
course.
PROCEDURE:
Bilateral common iliac stent, bilateral selective angiogram.
COMPLICATIONS:
None.
ESTIMATED BLOOD LOSS:
Less than 5 mL.
INDICATION FOR PROCEDURE:
Lifestyle limiting claudication, recurrent stenting.
DESCRIPTION OF PROCEDURE:
After informed consent, discussion of risks and benefits, a 5-French
sheath was placed in the right common femoral artery under ultrasound
guidance. Angiography was performed using a Contra catheter. The patient
has had 2 bare metal stents in the right common iliac and there are
2 areas of stenosis inside the stent of 90% in both in the proximal
edge and the distal edge. The patient was anticoagulated to a therapeutic
ACT. A 7-French sheath was placed. The artery was stented with a 8.0
x 58 atrium covered stent at 12 atmospheres of pressure to reach a size
of 8.5 with good apposition. We then took selective angiography of
the left. There was a significant lesion in the common femoral, but
there was no gradient across it. On pullback, there was a 60 mm gradient
in the common iliac, selective angiography confirmed 80 to 90% stenosis.
Of note, right internal iliac is totally occluded and is supplied through
sacral artery. The left internal iliac was patent. We decided to do
a non-covered stent. The artery was stented with a cobalt 8.0 x 27
stent at 10 atmospheres of pressure. The stent was post dilated proximally
by a 9.0 __________ x 15. We did lose the internal iliac on the left.
I am hoping that
this collateralizes through that same sacral collateral. The patient
was counseled on symptoms. Further recommendations to follow clinical
course.