Please help me in coding this IVR
Findings: After informed consent the neck was prepped and draped in sterile fashion.5ml 1% lidocaine was applied for local anesthesia.The right and left neck vasculature were evaluated under ultrasound.
The right and left internal jugular veins were occluded.
The right groin was then prepped and draped in sterile fashion.
5ml 1% watkins + local anesthesia.
The right groin vasculature was assessed with US.
A tiny right femoral vein was patent.This access was a micropuncture set and US guidance.
Sonographic augmentation was obtained.The wire was carefully advanced but would not advance centrally to the expected location of IVC.
Subsequent contrast injections were performed demonstrating multiple network of collaterals in the right groin region and right pelvis with no direct in-line flow into the IVC.
The needles and wires were removed and hemostasis achieved.
Impression:
1.Evaluation of the neck vasculature demonstrated total occlusion of the jugualr veins bilaterally.
2.Successful US guided vascular access of a tiny right femoral vein.Subsequent contrast injections demonstrated no direct in-line flow or out-flow into the IVC.
There was an extensive network of venous vascular collaterals within the right groin and right pelvis.
Thanks in advance
Findings: After informed consent the neck was prepped and draped in sterile fashion.5ml 1% lidocaine was applied for local anesthesia.The right and left neck vasculature were evaluated under ultrasound.
The right and left internal jugular veins were occluded.
The right groin was then prepped and draped in sterile fashion.
5ml 1% watkins + local anesthesia.
The right groin vasculature was assessed with US.
A tiny right femoral vein was patent.This access was a micropuncture set and US guidance.
Sonographic augmentation was obtained.The wire was carefully advanced but would not advance centrally to the expected location of IVC.
Subsequent contrast injections were performed demonstrating multiple network of collaterals in the right groin region and right pelvis with no direct in-line flow into the IVC.
The needles and wires were removed and hemostasis achieved.
Impression:
1.Evaluation of the neck vasculature demonstrated total occlusion of the jugualr veins bilaterally.
2.Successful US guided vascular access of a tiny right femoral vein.Subsequent contrast injections demonstrated no direct in-line flow or out-flow into the IVC.
There was an extensive network of venous vascular collaterals within the right groin and right pelvis.
Thanks in advance