Rita Bartholomew
Guru
Can I use 35471 here since it seems to be a diagnostic procedure rather than therapeutic?
INDICATION: RENAL HYPERTENSION
ABDOMINAL AORTOGRAM, RIGHT RENAL ARTERIOGRAM AND RIGHT RENAL ARTERY ANGIOPLASTY: The risks were explained and informed consent was obtained. Monitored conscious sedation was used for 40 minutes. A catheter was placed in the abdominal aorta using a Seldinger technique and an angiogram performed of the abdominal aorta. Selective catheterization was then performed of the right renal artery. It shows the vessel to be widely patent. It is smaller than the left but patent. I do not see any measurable stenosis. I placed a catheter across it and measured pressures. No pressure gradient was noted. I inflated a small balloon very gently in the ostium measuring 3.5 millimeters to evaluate for any web given the MRI appearance but there was no visible neck to the balloon and no stenosis was seen. The left renal artery is widely patent and normal. 40 minutes of monitored conscious sedation was used in total. An Angio-Seal was placed and the patient was discharged uneventfully.
IMPRESSION: The renal arteries are intact. I do not see any measurable stenosis. The renal parenchymal thickness appears intact. There is no evidence of measurable stenosis in the right side. I do not see any findings to suggest renal artery hypertension at this time.
INDICATION: RENAL HYPERTENSION
ABDOMINAL AORTOGRAM, RIGHT RENAL ARTERIOGRAM AND RIGHT RENAL ARTERY ANGIOPLASTY: The risks were explained and informed consent was obtained. Monitored conscious sedation was used for 40 minutes. A catheter was placed in the abdominal aorta using a Seldinger technique and an angiogram performed of the abdominal aorta. Selective catheterization was then performed of the right renal artery. It shows the vessel to be widely patent. It is smaller than the left but patent. I do not see any measurable stenosis. I placed a catheter across it and measured pressures. No pressure gradient was noted. I inflated a small balloon very gently in the ostium measuring 3.5 millimeters to evaluate for any web given the MRI appearance but there was no visible neck to the balloon and no stenosis was seen. The left renal artery is widely patent and normal. 40 minutes of monitored conscious sedation was used in total. An Angio-Seal was placed and the patient was discharged uneventfully.
IMPRESSION: The renal arteries are intact. I do not see any measurable stenosis. The renal parenchymal thickness appears intact. There is no evidence of measurable stenosis in the right side. I do not see any findings to suggest renal artery hypertension at this time.
