sharris01
New
Hello. still learning the ins and outs of coding IR. Would anyone like to chime in on this procedure. Thanks in advance.
PROCEDURE:
1. Right common femoral artery access under ultrasound guidance
2. Right common femoral and external iliac artery angiogram, nonselective
3. Pelvic aortogram and bilateral iliac angiogram, nonselective.
4. Left common iliac (1st order), internal iliac (2nd order), anterior
division internal iliac
(3rd order), prostate artery (3rd+ order) selective catheterization and
angiogram
5. Left prostate artery embolization for treatment of benign tumor (BPH)
6. Right common iliac (1st order), internal iliac (2nd order), anterior
division internal iliac
(3rd order), prostate artery (3rd+ order) selective catheterization and
angiogram
7. Right prostate artery embolization for treatment of benign tumor (BPH)
TECHNIQUE:
The patient was placed supine on the angiographic table and both groins were
prepped and draped in the usual sterile fashion.
Arterial access: Under direct ultrasound guidance, the patent right common femoral artery was
punctured with a 21-gauge micro puncture needle with visualization of the needle tip in the
accessed vessel. A 0.018 inch guidewire was advanced into the iliac artery under fluoroscopic
guidance. The needle was exchanged over the wire for a 5-French micro puncture introducer. The
introducer was exchanged over a 0.035 inch wire for a 5-French sheath.
Right common femoral and external iliac artery angiogram: Contrast injection into the arterial
access sheath demonstrated proper access location above the profunda femoris origin and below
the inguinal ligament. Vessel diameter is appropriate size for closure device.
Pelvic aortogram and bilateral iliac angiogram: A 5-French Omni flush catheter was inserted
over a Bentson wire and formed in the abdominal aorta. Pelvic aortogram and bilateral iliac
angiogram identified the origins of the internal iliac arteries. Prostate arteries were not
clearly identified.
Left common iliac artery, internal iliac artery, anterior division internal iliac artery, and
prostate artery selective catheterization and angiogram: A glide wire was inserted into the
Omni flush catheter and used to select the left common iliac artery and external iliac artery.
The Omni flush catheter was exchanged over the glide wire for a 5-French RBT catheter. The
catheter was used to select the anterior division internal iliac artery. Angiogram was
performed in the ipsilateral oblique. The prostate artery origin was identified. A 2.0 French
microcatheter and 0.016 inch microwire were used to select the prostate artery. Angiogram was
performed to confirm proper position. There are distal collateral penile branches.
Left prostate artery embolization: 100 mcg nitroglycerin was administered into the prostate
artery for vasodilation to prevent vasospasm to aid in better embolization. Left prostate
artery was embolized using 100–300-micron Embospheres to hemostasis.
Right common iliac artery, internal iliac artery, anterior division internal iliac artery, and
prostate artery selective catheterization and angiogram: The 5 French RBT catheter was
retracted into the abdominal aorta and used to select the right common iliac, internal iliac,
anterior division internal iliac artery. Angiogram in the ipsilateral oblique identified the
prostate artery origin. A 2.0 French microcatheter and 0.016 inch Fathom microwire were used to
select the prostate artery. Angiogram shows no collateral flow to the rectal or penile
branches.
Right prostate artery embolization: 100 mcg nitroglycerin was administered into the prostate
artery for vasodilation to prevent vasospasm to aid in better embolization. Left prostate
artery was embolized using 100–300-micron Embospheres to hemostasis. Coil embolization was
performed using 2 mm x 2 cm and 2 mm x 10 cm detachable low-profile Penumbra coils.
Closure: All wires, catheters, and sheaths were removed. Hemostasis at the right common femoral
artery access was achieved using a 6 French Angio-Seal closure device. Manual compression
applied for 2 minutes. Sterile dressing applied.
PROCEDURE:
1. Right common femoral artery access under ultrasound guidance
2. Right common femoral and external iliac artery angiogram, nonselective
3. Pelvic aortogram and bilateral iliac angiogram, nonselective.
4. Left common iliac (1st order), internal iliac (2nd order), anterior
division internal iliac
(3rd order), prostate artery (3rd+ order) selective catheterization and
angiogram
5. Left prostate artery embolization for treatment of benign tumor (BPH)
6. Right common iliac (1st order), internal iliac (2nd order), anterior
division internal iliac
(3rd order), prostate artery (3rd+ order) selective catheterization and
angiogram
7. Right prostate artery embolization for treatment of benign tumor (BPH)
TECHNIQUE:
The patient was placed supine on the angiographic table and both groins were
prepped and draped in the usual sterile fashion.
Arterial access: Under direct ultrasound guidance, the patent right common femoral artery was
punctured with a 21-gauge micro puncture needle with visualization of the needle tip in the
accessed vessel. A 0.018 inch guidewire was advanced into the iliac artery under fluoroscopic
guidance. The needle was exchanged over the wire for a 5-French micro puncture introducer. The
introducer was exchanged over a 0.035 inch wire for a 5-French sheath.
Right common femoral and external iliac artery angiogram: Contrast injection into the arterial
access sheath demonstrated proper access location above the profunda femoris origin and below
the inguinal ligament. Vessel diameter is appropriate size for closure device.
Pelvic aortogram and bilateral iliac angiogram: A 5-French Omni flush catheter was inserted
over a Bentson wire and formed in the abdominal aorta. Pelvic aortogram and bilateral iliac
angiogram identified the origins of the internal iliac arteries. Prostate arteries were not
clearly identified.
Left common iliac artery, internal iliac artery, anterior division internal iliac artery, and
prostate artery selective catheterization and angiogram: A glide wire was inserted into the
Omni flush catheter and used to select the left common iliac artery and external iliac artery.
The Omni flush catheter was exchanged over the glide wire for a 5-French RBT catheter. The
catheter was used to select the anterior division internal iliac artery. Angiogram was
performed in the ipsilateral oblique. The prostate artery origin was identified. A 2.0 French
microcatheter and 0.016 inch microwire were used to select the prostate artery. Angiogram was
performed to confirm proper position. There are distal collateral penile branches.
Left prostate artery embolization: 100 mcg nitroglycerin was administered into the prostate
artery for vasodilation to prevent vasospasm to aid in better embolization. Left prostate
artery was embolized using 100–300-micron Embospheres to hemostasis.
Right common iliac artery, internal iliac artery, anterior division internal iliac artery, and
prostate artery selective catheterization and angiogram: The 5 French RBT catheter was
retracted into the abdominal aorta and used to select the right common iliac, internal iliac,
anterior division internal iliac artery. Angiogram in the ipsilateral oblique identified the
prostate artery origin. A 2.0 French microcatheter and 0.016 inch Fathom microwire were used to
select the prostate artery. Angiogram shows no collateral flow to the rectal or penile
branches.
Right prostate artery embolization: 100 mcg nitroglycerin was administered into the prostate
artery for vasodilation to prevent vasospasm to aid in better embolization. Left prostate
artery was embolized using 100–300-micron Embospheres to hemostasis. Coil embolization was
performed using 2 mm x 2 cm and 2 mm x 10 cm detachable low-profile Penumbra coils.
Closure: All wires, catheters, and sheaths were removed. Hemostasis at the right common femoral
artery access was achieved using a 6 French Angio-Seal closure device. Manual compression
applied for 2 minutes. Sterile dressing applied.