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Don't do enough of these any help is greatly appreciated
NAME OF PROCEDURE: Renal angiogram.
INDICATIONS: Peripheral artery disease secondary to hypertension
renovascular.
HISTORY OF PRESENT ILLNESS: The patient is a 78-year-old with a history of
resistant hypertension, diabetes and peripheral artery disease who presents
with uncontrolled hypertension despite multiple medications including a
diuretic. He also developed hyperkalemia associated with an ARB. He
underwent a renal ultrasound that implied significant right renal artery
stenosis and in this context of resistant hypertension despite medical
therapy, it was elected to proceed with renal angiography.
PROCEDURE: Informed consent was obtained. The patient understood the risks,
benefits and alternatives of the procedure and agreed to proceed with the
procedure. The right groin was prepped and draped in sterile fashion and 2%
lidocaine infused subcutaneously until adequate anesthesia was obtained. The
right common femoral artery was accessed using modified Seldinger technique
through which a 6-French 11 cm sheath was placed without complication. A
5-French IMA catheter was used for selective renal angiography. At the
conclusion of the procedure, an Angio-Seal device was deployed without
complication for adequate arterial hemostasis.
FINDINGS: The right renal artery was selectively engaged with the catheter.
There was adequate catheter reflux and good opacification of the artery and
also all the renal vessels. There was evidence of mild ostial disease
approximately 10% stenosis. The left renal artery was also selectively
engaged with the catheter. There was adequate catheter reflux with no
significant stenosis and good opacification of the distal renal arteries.
Renal sizes on both the left and right were also normal.
Dr says to bill
36252-26
75716-26
36140
Not sure
NAME OF PROCEDURE: Renal angiogram.
INDICATIONS: Peripheral artery disease secondary to hypertension
renovascular.
HISTORY OF PRESENT ILLNESS: The patient is a 78-year-old with a history of
resistant hypertension, diabetes and peripheral artery disease who presents
with uncontrolled hypertension despite multiple medications including a
diuretic. He also developed hyperkalemia associated with an ARB. He
underwent a renal ultrasound that implied significant right renal artery
stenosis and in this context of resistant hypertension despite medical
therapy, it was elected to proceed with renal angiography.
PROCEDURE: Informed consent was obtained. The patient understood the risks,
benefits and alternatives of the procedure and agreed to proceed with the
procedure. The right groin was prepped and draped in sterile fashion and 2%
lidocaine infused subcutaneously until adequate anesthesia was obtained. The
right common femoral artery was accessed using modified Seldinger technique
through which a 6-French 11 cm sheath was placed without complication. A
5-French IMA catheter was used for selective renal angiography. At the
conclusion of the procedure, an Angio-Seal device was deployed without
complication for adequate arterial hemostasis.
FINDINGS: The right renal artery was selectively engaged with the catheter.
There was adequate catheter reflux and good opacification of the artery and
also all the renal vessels. There was evidence of mild ostial disease
approximately 10% stenosis. The left renal artery was also selectively
engaged with the catheter. There was adequate catheter reflux with no
significant stenosis and good opacification of the distal renal arteries.
Renal sizes on both the left and right were also normal.
Dr says to bill
36252-26
75716-26
36140
Not sure