Determined1
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PREOPERATIVE DIAGNOSIS: Severe peripheral vascular disease with atherosclerosis of the right leg. Nonhealing amputation right foot.
POSTOPERATIVE DIAGNOSIS: Severe peripheral vascular disease with atherosclerosis of the right leg. Nonhealing amputation right foot.
PROCEDURE PERFORMED: Diagnostic arteriogram of the pelvis and right lower extremity runoff. Artherectomy of the proximal superficial femoral artery and intravascular stenting of the mid superficial femoral artery. (Do not code the arteriogram in PCS)
This 51 year old male recently had a midfoot amputation on the right side which has not been healing. He is known to have peripheral vascular disease and previously underwent balloon angioplasty of the right superficial femoral artery. The patient has returned with a nonhealing nature of the wound and a Doppler ultrasound showing elevated velocities in the superficial femoral artery.
The femoral artery was punctured; a Bentson wire was inserted into the abdominal aorta. An Omni flush catheter was inserted into the lower abdominal aorta where a lower aortogram and bilateral pelvis arteriogram were performed. The common and external iliac arteries were traversed with our catheter at the level of the common femoral artery on the right. We performed an arteriogram at that point. We opted for intervention.
The patient was anticoagulated with 4000 units of heparin intravenously. The stenotic area in the superficial femoral artery was crossed with a Miracle Brothers wire and was advanced into the popliteal artery. The high grade stenosis of the origin of the superficial femoral artery was treated with artherectomy in the blades-down and blades-up position. Total artherectomy time was 52 seconds. Follow up arteriogram demonstrated some improvement. However, significant stenosis still present. A 5mm in 4 cm AngioSculpt balloon was used. Still residual stenosis. We then used a 6mm into 4cm balloon angioplasty with good result. A 6mm into 100mm Smart stent was deployed and post-dilated using 6mm balloon with good result. Closure was carried out using 6-French StarClose device. No complications.
Can anyone help me out with this? The only thing I can come up with is 36140
Thank you!!!!
POSTOPERATIVE DIAGNOSIS: Severe peripheral vascular disease with atherosclerosis of the right leg. Nonhealing amputation right foot.
PROCEDURE PERFORMED: Diagnostic arteriogram of the pelvis and right lower extremity runoff. Artherectomy of the proximal superficial femoral artery and intravascular stenting of the mid superficial femoral artery. (Do not code the arteriogram in PCS)
This 51 year old male recently had a midfoot amputation on the right side which has not been healing. He is known to have peripheral vascular disease and previously underwent balloon angioplasty of the right superficial femoral artery. The patient has returned with a nonhealing nature of the wound and a Doppler ultrasound showing elevated velocities in the superficial femoral artery.
The femoral artery was punctured; a Bentson wire was inserted into the abdominal aorta. An Omni flush catheter was inserted into the lower abdominal aorta where a lower aortogram and bilateral pelvis arteriogram were performed. The common and external iliac arteries were traversed with our catheter at the level of the common femoral artery on the right. We performed an arteriogram at that point. We opted for intervention.
The patient was anticoagulated with 4000 units of heparin intravenously. The stenotic area in the superficial femoral artery was crossed with a Miracle Brothers wire and was advanced into the popliteal artery. The high grade stenosis of the origin of the superficial femoral artery was treated with artherectomy in the blades-down and blades-up position. Total artherectomy time was 52 seconds. Follow up arteriogram demonstrated some improvement. However, significant stenosis still present. A 5mm in 4 cm AngioSculpt balloon was used. Still residual stenosis. We then used a 6mm into 4cm balloon angioplasty with good result. A 6mm into 100mm Smart stent was deployed and post-dilated using 6mm balloon with good result. Closure was carried out using 6-French StarClose device. No complications.
Can anyone help me out with this? The only thing I can come up with is 36140
Thank you!!!!
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