suela923@aol.com
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The way I am reading this I would not bill for the angioplasty only the stent...is that correct, if not please explain. Thanks so much!
INDICATION FOR TESTING
Severe ostial left subclavian stenosis with utilized left internal mammary artery to the LAD and possible subclavian steal syndrome.
DESCRIPTION
Mr. X was taken to the Interventional Radiology department where bilateral groins were prepped in the usual fashion. Moderate sedation and local anesthesia were used throughout the procedure as well as IV heparin for an ACT greater than 250. His right common femoral artery was accessed utilizing a 6-French sheath. A 90-cm sheath was then used to advance up to the ostium of the left subclavian artery. Selective angiography was performed of the left subclavian artery to utilize its stenosis. Following this, a V18 wire was used to go past the lesion, and the ostial subclavian lesion was predilated with a 4.0 balloon. Following this, a 6.0 x 18 bare-metal stent was deployed in the ostial area and post-dilated with an 8.0 balloon with 0% residual. The wire was then removed, and final angiography demonstrated brisk flow at the left subclavian artery and down the left internal mammary artery. Right iliofemoral angiography was also performed, and the right common femoral artery was deemed suitable for vascular closure device, which was successful. He was then transferred back to the recovery unit, was monitored per protocol, and then was deemed stable for discharge on the same day of procedure.
IMPRESSION
Selective angiography of the left subclavian artery.
Successful PTA and stenting with a 6.0 x 18 bare-metal stent with 0% residual
INDICATION FOR TESTING
Severe ostial left subclavian stenosis with utilized left internal mammary artery to the LAD and possible subclavian steal syndrome.
DESCRIPTION
Mr. X was taken to the Interventional Radiology department where bilateral groins were prepped in the usual fashion. Moderate sedation and local anesthesia were used throughout the procedure as well as IV heparin for an ACT greater than 250. His right common femoral artery was accessed utilizing a 6-French sheath. A 90-cm sheath was then used to advance up to the ostium of the left subclavian artery. Selective angiography was performed of the left subclavian artery to utilize its stenosis. Following this, a V18 wire was used to go past the lesion, and the ostial subclavian lesion was predilated with a 4.0 balloon. Following this, a 6.0 x 18 bare-metal stent was deployed in the ostial area and post-dilated with an 8.0 balloon with 0% residual. The wire was then removed, and final angiography demonstrated brisk flow at the left subclavian artery and down the left internal mammary artery. Right iliofemoral angiography was also performed, and the right common femoral artery was deemed suitable for vascular closure device, which was successful. He was then transferred back to the recovery unit, was monitored per protocol, and then was deemed stable for discharge on the same day of procedure.
IMPRESSION
Selective angiography of the left subclavian artery.
Successful PTA and stenting with a 6.0 x 18 bare-metal stent with 0% residual