gricelarce
Guest
This was coded 37228-Rt & 37226-Rt, but I think it's missing this code 37232. any suggestion?
Summary:
* Abdominal aortogram.
* Right selective unilateral lower extremity peripheral angiogram.
* Right distal popliteal artery: angioplasty.
* Right tibio peroneal trunk: angioplasty.
* Right proximal peroneal artery: angioplasty.
* Right mid superficial femoral artery: stent and angioplasty.
* Access artery: left mid common femoral artery, retrograde.
- Destination artery: distal abdominal aorta and right mid peroneal artery.
- Closure Type: mynx.
Anesthesia:
Local anesthesia: 1% lidocaine
Other Drugs:
9000 units unfractionated Heparin
Indication:
The patient is a 81 years old male. Patient has typical claudication and critical limb ischemia. Patient has rest
pain (left). Patient has rest pain (right).
Technique:
The patient was brought to the endovascular suite, placed in a supine position and draped in routine sterile
fashion. All aspects of the 'time-out' verification were satisfactorily completed prior to the beginning of the
procedure. The right groin region and left groin region were prepped. Local anesthesia was administered using
1% lidocaine.
The left mid common femoral artery was accessed in a retrograde fashion using a micropuncture needle
access site is used for diagnostic purpose only. A guide wire was introduced through the needle. The needle
was removed. Then, a wire and catheter were advanced to the distal abdominal aorta. Then, a wire and
catheter were advanced to the right mid peroneal artery. After carefully reviewing the diagnostic angiogram, it
was decided to proceed with intervention.The sheath was removed and upsized for 5-Fr x 45 cm sheath. The
sheath was placed in right common femoral artery.
Intervention:
A catheter was placed over the wire in the right distal popliteal artery. 3 mm x 100 mm balloon angioplasty
was performed on the vessel. The balloon was inflated at (____) atm for 120 sec.
A catheter was placed over the wire in the right tibio peroneal trunk. 3 mm x 100 mm balloon angioplasty was
performed on the vessel. The balloon was inflated at (____) atm for 120 sec.
A catheter was placed over the wire in the right proximal peroneal artery. 2.5 mm x 100 mm balloon
angioplasty was performed on the vessel. The balloon was inflated at (____) atm for 120 sec.
A catheter was placed over the wire in the right mid superficial femoral artery. 6 mm x 60 mm stent was
successfully deployed in the vessel. 6 mm x 100 mm balloon angioplasty was performed on the vessel. The
balloon was inflated at (____) atm for 120 sec.
Hemostasis:
All wires, catheters, and sheaths were removed. The puncture site was closed using a mynx. Manual
compression was applied for 20 minutes. A pressure dressing was applied to the access site. Satisfactory
hemostasis was achieved in the left mid common femoral artery.
Findings:
Right common iliac artery: patent. Right external iliac: patent. Right common femoral artery: patent. Right
profunda artery: patent. Right proximal superficial femoral artery: 20% stenosis. Right mid superficial femoral
artery: 80% instent restenosis. Right distal superficial femoral artery: patent. Right proximal popliteal artery:
patent. Right mid popliteal artery: patent. Right distal popliteal artery: 60% stenosis. Right tibio peroneal
trunk: 60% stenosis. Right proximal peroneal artery: 80% stenosis. Right mid peroneal artery: patent. Right
distal peroneal artery: patent. Right proximal posterior tibial artery: patent. Right mid posterior tibial artery:
patent. Right distal posterior tibial artery: patent.
Left common iliac artery: patent. Left external iliac: patent. Left common femoral artery: patent.
Summary:
* Abdominal aortogram.
* Right selective unilateral lower extremity peripheral angiogram.
* Right distal popliteal artery: angioplasty.
* Right tibio peroneal trunk: angioplasty.
* Right proximal peroneal artery: angioplasty.
* Right mid superficial femoral artery: stent and angioplasty.
* Access artery: left mid common femoral artery, retrograde.
- Destination artery: distal abdominal aorta and right mid peroneal artery.
- Closure Type: mynx.
Anesthesia:
Local anesthesia: 1% lidocaine
Other Drugs:
9000 units unfractionated Heparin
Indication:
The patient is a 81 years old male. Patient has typical claudication and critical limb ischemia. Patient has rest
pain (left). Patient has rest pain (right).
Technique:
The patient was brought to the endovascular suite, placed in a supine position and draped in routine sterile
fashion. All aspects of the 'time-out' verification were satisfactorily completed prior to the beginning of the
procedure. The right groin region and left groin region were prepped. Local anesthesia was administered using
1% lidocaine.
The left mid common femoral artery was accessed in a retrograde fashion using a micropuncture needle
access site is used for diagnostic purpose only. A guide wire was introduced through the needle. The needle
was removed. Then, a wire and catheter were advanced to the distal abdominal aorta. Then, a wire and
catheter were advanced to the right mid peroneal artery. After carefully reviewing the diagnostic angiogram, it
was decided to proceed with intervention.The sheath was removed and upsized for 5-Fr x 45 cm sheath. The
sheath was placed in right common femoral artery.
Intervention:
A catheter was placed over the wire in the right distal popliteal artery. 3 mm x 100 mm balloon angioplasty
was performed on the vessel. The balloon was inflated at (____) atm for 120 sec.
A catheter was placed over the wire in the right tibio peroneal trunk. 3 mm x 100 mm balloon angioplasty was
performed on the vessel. The balloon was inflated at (____) atm for 120 sec.
A catheter was placed over the wire in the right proximal peroneal artery. 2.5 mm x 100 mm balloon
angioplasty was performed on the vessel. The balloon was inflated at (____) atm for 120 sec.
A catheter was placed over the wire in the right mid superficial femoral artery. 6 mm x 60 mm stent was
successfully deployed in the vessel. 6 mm x 100 mm balloon angioplasty was performed on the vessel. The
balloon was inflated at (____) atm for 120 sec.
Hemostasis:
All wires, catheters, and sheaths were removed. The puncture site was closed using a mynx. Manual
compression was applied for 20 minutes. A pressure dressing was applied to the access site. Satisfactory
hemostasis was achieved in the left mid common femoral artery.
Findings:
Right common iliac artery: patent. Right external iliac: patent. Right common femoral artery: patent. Right
profunda artery: patent. Right proximal superficial femoral artery: 20% stenosis. Right mid superficial femoral
artery: 80% instent restenosis. Right distal superficial femoral artery: patent. Right proximal popliteal artery:
patent. Right mid popliteal artery: patent. Right distal popliteal artery: 60% stenosis. Right tibio peroneal
trunk: 60% stenosis. Right proximal peroneal artery: 80% stenosis. Right mid peroneal artery: patent. Right
distal peroneal artery: patent. Right proximal posterior tibial artery: patent. Right mid posterior tibial artery:
patent. Right distal posterior tibial artery: patent.
Left common iliac artery: patent. Left external iliac: patent. Left common femoral artery: patent.