cdc1cori
New
Can somebody please give me some guidance on the following. This dr. is filling in for our normal IR dr, and I'm thinking his dictation is lacking...to say the least! 
AV Dialysis Shunt
Ultrasound guidance and arteriogram of the left arm
autologous AV shunt fistula. Indication symptomatic swelling of
the left arm. ASA class II local lidocaine and moderate
sedation ultrasound guidance to the fistula is recorded with
flow on PACS and fistulogram obtained. The patient shows
multiple stenosis which were all angioplastied with a 10 mm x 4
mm balloon.
Findings: on the original arteriogram the patient shows
multiple sclerosis at the level of the cephalic vein, the
cephalic arch the innominate and the subclavian vein. No flow
is seen through the innominate vein itself. The flow return is
through collaterals. I was able to place a catheter and wire
and the 10 mm by 4 cm angioplasty balloon to perform
angioplasty. Balloon angioplasty performed at the level of the
left innominate vein. The subclavian vein. The cephalic vein.
This where the stents are No complications the arterial
anastomosis is patent. Aneurysmal enlargement at the level of
the proximal vein noted.
Summary: Significant outflow stenosis which was addressed by
multiple angioplasties the followup arteriogram shows
improvement in that there is now in-line flow point through the
cephalic vein to the subclavian and the innominate vein to the
SVC ; no complications
IMPRESSION: Ultrasound guidance and arteriogram of the left
arm autologous AV shunt fistula. Indication symptomatic
swelling of the left arm. ASA class II local lidocaine and
moderate sedation ultrasound guidance to the fistula is
recorded with flow on PACS and fistulogram obtained. The
patient shows multiple stenosis which were all angioplastied
with a 10 mm x 4 mm balloon.
Findings: on the original arteriogram the patient shows
multiple sclerosis at the level of the cephalic vein, the
cephalic arch the innominate and the subclavian vein. No flow
is seen through the innominate vein itself. The flow return is
through collaterals. I was able to place a catheter and wire
and the 10 mm by 4 cm angioplasty balloon to perform
angioplasty. Balloon angioplasty performed at the level of the
left innominate vein. The subclavian vein. The cephalic vein.
This where the stents are No complications the arterial
anastomosis is patent. Aneurysmal enlargement at the level of
the proximal vein noted.
Summary: Significant outflow stenosis which was addressed by
multiple angioplasties the followup arteriogram shows
improvement in that there is now in-line flow point through the
cephalic vein to the subclavian and the innominate vein to the
SVC ; no complications
AV Dialysis Shunt
Ultrasound guidance and arteriogram of the left arm
autologous AV shunt fistula. Indication symptomatic swelling of
the left arm. ASA class II local lidocaine and moderate
sedation ultrasound guidance to the fistula is recorded with
flow on PACS and fistulogram obtained. The patient shows
multiple stenosis which were all angioplastied with a 10 mm x 4
mm balloon.
Findings: on the original arteriogram the patient shows
multiple sclerosis at the level of the cephalic vein, the
cephalic arch the innominate and the subclavian vein. No flow
is seen through the innominate vein itself. The flow return is
through collaterals. I was able to place a catheter and wire
and the 10 mm by 4 cm angioplasty balloon to perform
angioplasty. Balloon angioplasty performed at the level of the
left innominate vein. The subclavian vein. The cephalic vein.
This where the stents are No complications the arterial
anastomosis is patent. Aneurysmal enlargement at the level of
the proximal vein noted.
Summary: Significant outflow stenosis which was addressed by
multiple angioplasties the followup arteriogram shows
improvement in that there is now in-line flow point through the
cephalic vein to the subclavian and the innominate vein to the
SVC ; no complications
IMPRESSION: Ultrasound guidance and arteriogram of the left
arm autologous AV shunt fistula. Indication symptomatic
swelling of the left arm. ASA class II local lidocaine and
moderate sedation ultrasound guidance to the fistula is
recorded with flow on PACS and fistulogram obtained. The
patient shows multiple stenosis which were all angioplastied
with a 10 mm x 4 mm balloon.
Findings: on the original arteriogram the patient shows
multiple sclerosis at the level of the cephalic vein, the
cephalic arch the innominate and the subclavian vein. No flow
is seen through the innominate vein itself. The flow return is
through collaterals. I was able to place a catheter and wire
and the 10 mm by 4 cm angioplasty balloon to perform
angioplasty. Balloon angioplasty performed at the level of the
left innominate vein. The subclavian vein. The cephalic vein.
This where the stents are No complications the arterial
anastomosis is patent. Aneurysmal enlargement at the level of
the proximal vein noted.
Summary: Significant outflow stenosis which was addressed by
multiple angioplasties the followup arteriogram shows
improvement in that there is now in-line flow point through the
cephalic vein to the subclavian and the innominate vein to the
SVC ; no complications