AshleyMartin
Networker
This one really has me confused. This is what I have, please let me know if I am coding this correctly:
36216-RT
36215-LT-59
75671-26
75680-26-59
75605-26-59
36245-LT
75625-26
75716-26-59
Here is the report:
Procedures: Aortic Arch, Selective Carotid/Cerebral Angio, Abdominal Aortogram w/bilat runoff
Access was obtained via the right femoral artery via modified Seldinger technique after 1% lidocaine was used to anesthetize the area. This was done using a Bentson wire. We were able to place a 6-French sheath in and flush without any complications. We introduced initially a pigtail catheter. Aortic arch was performed. We then performed abdominal aortogram. We then switched to a Berenstein catheter. We were able to selectively engage both carotid arteries using an angled Glidewire. Angiography was performed using biplane as well and the cerebral images taken. We then used an Omni flush catheter to cross over the aortoiliac bifurcation. Selective angiographic shots of the left lower extremity were taken. Took selective right lower extremity pictures through the sheath. The sheath was then pulled and hemostasis was achieved using manual pressure.
Findings:
1. Right subclavian artery is subtotally occluded.
2. Right common carotid artery is free of disease. The right internal carotid artery has a 90% lesion. It fills the MCA. The ACA appears to be occluded.
3. Left common carotid appears free of disease. Left ICA has a 50% lesion at the takeoff, fills the MCA and ACA on the left.
4. Bilateral renal arteries are not visualized well enough to comment.
5. Distal abdominal aorta tapers at the bifurcation. There is no evidence of aneurysm or dissection.
6. Bilateral iliacs have diffuse disease. There is a focal 80%-90% lesion in the left common iliac artery. There is diffuse disease through the right common and external with a focal 80% lesion right at the junction of the iliacs between the external and common. Both internal iliacs are occluded.
7. Right common femoral artery is essentially occluded. The SFA has diffuse disease, it is kind of a small vessel in caliber, however patent through the popliteal to the infrapopliteal vessels. There is 1 and 1.5 runoff to the foot, mostly consisting of the peroneal.
8. Left SFA has some proximal significant disease. Again it is a small vessel with diffuse disease throughtout and extending into the popliteal and down to the trifurcation. The is 1 and 1.5 runoff to the foot, mainly again consisting of the peroneal.
Any feedback would be greatly appreciated! Thanks!
36216-RT
36215-LT-59
75671-26
75680-26-59
75605-26-59
36245-LT
75625-26
75716-26-59
Here is the report:
Procedures: Aortic Arch, Selective Carotid/Cerebral Angio, Abdominal Aortogram w/bilat runoff
Access was obtained via the right femoral artery via modified Seldinger technique after 1% lidocaine was used to anesthetize the area. This was done using a Bentson wire. We were able to place a 6-French sheath in and flush without any complications. We introduced initially a pigtail catheter. Aortic arch was performed. We then performed abdominal aortogram. We then switched to a Berenstein catheter. We were able to selectively engage both carotid arteries using an angled Glidewire. Angiography was performed using biplane as well and the cerebral images taken. We then used an Omni flush catheter to cross over the aortoiliac bifurcation. Selective angiographic shots of the left lower extremity were taken. Took selective right lower extremity pictures through the sheath. The sheath was then pulled and hemostasis was achieved using manual pressure.
Findings:
1. Right subclavian artery is subtotally occluded.
2. Right common carotid artery is free of disease. The right internal carotid artery has a 90% lesion. It fills the MCA. The ACA appears to be occluded.
3. Left common carotid appears free of disease. Left ICA has a 50% lesion at the takeoff, fills the MCA and ACA on the left.
4. Bilateral renal arteries are not visualized well enough to comment.
5. Distal abdominal aorta tapers at the bifurcation. There is no evidence of aneurysm or dissection.
6. Bilateral iliacs have diffuse disease. There is a focal 80%-90% lesion in the left common iliac artery. There is diffuse disease through the right common and external with a focal 80% lesion right at the junction of the iliacs between the external and common. Both internal iliacs are occluded.
7. Right common femoral artery is essentially occluded. The SFA has diffuse disease, it is kind of a small vessel in caliber, however patent through the popliteal to the infrapopliteal vessels. There is 1 and 1.5 runoff to the foot, mostly consisting of the peroneal.
8. Left SFA has some proximal significant disease. Again it is a small vessel with diffuse disease throughtout and extending into the popliteal and down to the trifurcation. The is 1 and 1.5 runoff to the foot, mainly again consisting of the peroneal.
Any feedback would be greatly appreciated! Thanks!