willnat2
Networker
I could really use some help with this procedure, please.
Procedure Performed:
Common Iliac Angiogram-Bilateral
Bilateral Lower Extremity Angio
Renal Angiogram- Bilateral
PTA Right Proximal SFA, Right Femoral, Right External Iliac, and Right Common Iliac Arteries
Thrombectomy Right Peroneal Artery and Right Anterior Tibial Artery
PTA Right Peroneal and Right Anterior Tibal Arteries
INDICATIONS:
Diag Indication: PVD Unspecified 443.9
Disabling Claudicaton of the RT Lower Extremity
PROCEDURE:
After obtaining informed consent, the patient was transferred to the Cardiac Cath Lab in stable condition. The patient was draped and prepped in a sterile fashion. No prior angiograms were done prior to the pt's sx.
The groin was anethetizaed locally using 1% Lidocaine. The Left femoral artery was canulated using a modified Seldinger technique and a 6 French arterial sheath was introduced. A 6 French diagnostic catheter was then advanced to the renal ostium and angiography was performed of the renals, Aorta and Bilateral Iliacs, Femerol, Popliteal, Tibiais, and Peroneal.
A 6 F Crossover sheath was placed into the the R Iliac and a .035 wire was placed into the distal Popliteal A 200mm 6.0 Balloon was used to dilate the Femerol and Iliac arteries. We had a very good result after serial inflations but material embolised distally. This required aspiration catheters of the Tibial perineal trunk and PTCA of the Perineal and Ant. Tibial.
The sheath was removed without difficulty. Pt. tolerated procedure well.
PERIPHERAL FINDINGS:
Lt Renal Discrete 35% lesion
Rt Renal Normal 0% lesion
Lt Renal (Ostial), Discrete 35% lesion
Aorta (Mid), Luminal Irregularities 15% lesion
Collateral flow from Rt Int. Iliac to Rt SFA
Rt Common Femoral (Mid), Discrete 100% lesion
Lt Ext. Iliac (Mid), Discrete 50% lesion
Rt Ext. Iliac (Ostial), Discrete 100% lesion Stent to 100%
Lt Ant. Tibial (Proximal ), Discrete 90% lesion
CONCLUSION:
Successful PTCA with arterial aspiration of the Right Iliac, Femerol, Peroneal and Anterior Tibial Arteries 100% to <10% Iliacs and Fermerol with subtotal occ of the Ant Tibial due to plaque shifting.
36252
75716,O 59
37220 RT
37224 RT
37228 RT
37232 RT
37232 RT
37186
I am not sure if this is correct and need some help please.
Procedure Performed:
Common Iliac Angiogram-Bilateral
Bilateral Lower Extremity Angio
Renal Angiogram- Bilateral
PTA Right Proximal SFA, Right Femoral, Right External Iliac, and Right Common Iliac Arteries
Thrombectomy Right Peroneal Artery and Right Anterior Tibial Artery
PTA Right Peroneal and Right Anterior Tibal Arteries
INDICATIONS:
Diag Indication: PVD Unspecified 443.9
Disabling Claudicaton of the RT Lower Extremity
PROCEDURE:
After obtaining informed consent, the patient was transferred to the Cardiac Cath Lab in stable condition. The patient was draped and prepped in a sterile fashion. No prior angiograms were done prior to the pt's sx.
The groin was anethetizaed locally using 1% Lidocaine. The Left femoral artery was canulated using a modified Seldinger technique and a 6 French arterial sheath was introduced. A 6 French diagnostic catheter was then advanced to the renal ostium and angiography was performed of the renals, Aorta and Bilateral Iliacs, Femerol, Popliteal, Tibiais, and Peroneal.
A 6 F Crossover sheath was placed into the the R Iliac and a .035 wire was placed into the distal Popliteal A 200mm 6.0 Balloon was used to dilate the Femerol and Iliac arteries. We had a very good result after serial inflations but material embolised distally. This required aspiration catheters of the Tibial perineal trunk and PTCA of the Perineal and Ant. Tibial.
The sheath was removed without difficulty. Pt. tolerated procedure well.
PERIPHERAL FINDINGS:
Lt Renal Discrete 35% lesion
Rt Renal Normal 0% lesion
Lt Renal (Ostial), Discrete 35% lesion
Aorta (Mid), Luminal Irregularities 15% lesion
Collateral flow from Rt Int. Iliac to Rt SFA
Rt Common Femoral (Mid), Discrete 100% lesion
Lt Ext. Iliac (Mid), Discrete 50% lesion
Rt Ext. Iliac (Ostial), Discrete 100% lesion Stent to 100%
Lt Ant. Tibial (Proximal ), Discrete 90% lesion
CONCLUSION:
Successful PTCA with arterial aspiration of the Right Iliac, Femerol, Peroneal and Anterior Tibial Arteries 100% to <10% Iliacs and Fermerol with subtotal occ of the Ant Tibial due to plaque shifting.
36252
75716,O 59
37220 RT
37224 RT
37228 RT
37232 RT
37232 RT
37186
I am not sure if this is correct and need some help please.