nlbarnes
Expert
36902 or 37246?
PROCEDURE:
Using ultrasound guidance, the
outflow vein was cannulated away from the anastomosis of the fistula.
Using a micro wire and dilator introducer kit, the outflow vein was
cannulated and upsized to an 0.035 wire. A picture was taken with the
ultrasound and sent off into the chart. A J-wire was placed centrally
and the micro wire dilator introducer sheath was exchanged for a short
6-French sheath. Through this, a fistulogram was obtained, which
demonstrated no outflow stenosis in the cephalic vein but, however,
more centrally, the collateral pattern suggested a stenosis at the
proximal region of the subclavian stent. Therefore, this lesion was
crossed and balloon angioplastied over a stiff wire using a 10 mm
balloon. Completion demonstrated improved flow dynamics, which
suggested that there was some short-segment stenosis or web, which had
been treated. All wires and sheaths were removed. Pressure was held
for 25 minutes and the dressing was hemostatic at the completion.
600214884
PROCEDURE:
Using ultrasound guidance, the
outflow vein was cannulated away from the anastomosis of the fistula.
Using a micro wire and dilator introducer kit, the outflow vein was
cannulated and upsized to an 0.035 wire. A picture was taken with the
ultrasound and sent off into the chart. A J-wire was placed centrally
and the micro wire dilator introducer sheath was exchanged for a short
6-French sheath. Through this, a fistulogram was obtained, which
demonstrated no outflow stenosis in the cephalic vein but, however,
more centrally, the collateral pattern suggested a stenosis at the
proximal region of the subclavian stent. Therefore, this lesion was
crossed and balloon angioplastied over a stiff wire using a 10 mm
balloon. Completion demonstrated improved flow dynamics, which
suggested that there was some short-segment stenosis or web, which had
been treated. All wires and sheaths were removed. Pressure was held
for 25 minutes and the dressing was hemostatic at the completion.
600214884