I have something I've never ever come across before. Patient had come to the cath lab for a pacemaker insert. Under fluroscopy the electrophysiologist noticed there was a guidewire located from the superior vena cava through the left atrium into the pelvis. My provider was requested to do the following. Any help would be greatly appreciated....
Indication: Wire dislodged in the superior vena cava.
Study: Left femoral venogram and retrieval of guiding wire.
Procedure: The left groin was anesthetized with 2% Lidocaine. Subsequently, a 7 French sheath was placed into the left femoral vein. Then, a left femoral venogram showed the wire J-tip was located in the left internal iliac vein subsequently under fluoroscopic guidance. A 6 French 90 cm sheath was placed into the superior vena cava. Then, an initial attempt to withdraw the wire using a small basket retrieval device was unsuccessful. After that, a 9x8 basket was able to grab the superior tip of the wire and then an attempt to pull the wire down was abandoned due to the fact that the wire was crossed over the pacing leads. Then, the wire was moved superiorly into the subclavian vein. Then, the basket was located into the inferior vena cava. Then, the J-tip was grabbed using the basket retrieval device and was removed from the body. This is the guiding wire from the sheath placement.
What I figured will be 75820-26 for the venography and 36000 for the catheter placement into the femoral vein. What about this guidewire removal???
Jessica CPC, CCC
Indication: Wire dislodged in the superior vena cava.
Study: Left femoral venogram and retrieval of guiding wire.
Procedure: The left groin was anesthetized with 2% Lidocaine. Subsequently, a 7 French sheath was placed into the left femoral vein. Then, a left femoral venogram showed the wire J-tip was located in the left internal iliac vein subsequently under fluoroscopic guidance. A 6 French 90 cm sheath was placed into the superior vena cava. Then, an initial attempt to withdraw the wire using a small basket retrieval device was unsuccessful. After that, a 9x8 basket was able to grab the superior tip of the wire and then an attempt to pull the wire down was abandoned due to the fact that the wire was crossed over the pacing leads. Then, the wire was moved superiorly into the subclavian vein. Then, the basket was located into the inferior vena cava. Then, the J-tip was grabbed using the basket retrieval device and was removed from the body. This is the guiding wire from the sheath placement.
What I figured will be 75820-26 for the venography and 36000 for the catheter placement into the femoral vein. What about this guidewire removal???
Jessica CPC, CCC
