Rebecca.Berry
Contributor
have a scenerio that I need help with tge correct codes. Please HELP!
PREOPERATIVE Diagnosis: Severe Peripheral vascular disease with right foot ulcer. Non Healing amputation non healing foot
POSTOPERATIVE: Severe peripheral vascular disease with right foot ulcer. Non healing Amputation right foot
Procedure Performed: Diagnostic arteriogram of the pelvis and right lower extremity runoff> Arthrectomy of the proximal superficial femoral artery and intravasculer stenting of the mid superficial femoral artery.
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 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 wherea lower aortogram and bilateral pelvis arteriogram were performed. The common and external iliac arteries were traversed with our catheter at the level of teh common femoral artery on the right. We performed a arteriogram at the 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 Miralce Brothers wire and was advanced into the popliteal artery. The high grade stenosis of the origin of the superficial femoral artery was treated with arthrectomy in the bladesdown nad blades-up position. Total 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 4 cm balloon angioplasty with good result. A 6mm into 100 mm Smart stent was deployed and post-dilated using 6mm balloon with good result.. Closure was carried out using a 6-French Starclose device. No Complications
Help Needed
PREOPERATIVE Diagnosis: Severe Peripheral vascular disease with right foot ulcer. Non Healing amputation non healing foot
POSTOPERATIVE: Severe peripheral vascular disease with right foot ulcer. Non healing Amputation right foot
Procedure Performed: Diagnostic arteriogram of the pelvis and right lower extremity runoff> Arthrectomy of the proximal superficial femoral artery and intravasculer stenting of the mid superficial femoral artery.
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 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 wherea lower aortogram and bilateral pelvis arteriogram were performed. The common and external iliac arteries were traversed with our catheter at the level of teh common femoral artery on the right. We performed a arteriogram at the 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 Miralce Brothers wire and was advanced into the popliteal artery. The high grade stenosis of the origin of the superficial femoral artery was treated with arthrectomy in the bladesdown nad blades-up position. Total 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 4 cm balloon angioplasty with good result. A 6mm into 100 mm Smart stent was deployed and post-dilated using 6mm balloon with good result.. Closure was carried out using a 6-French Starclose device. No Complications
Help Needed