Robbin109
Expert
Help! I haven't coded any carotid procedure since the codes recently changed!! 
PROCEDURE:
1. Diagnostic-Selective carotid arteriography
2. PTA as well as stenting of a high-grade stenosis of the distal common carotid and proximal internal carotid on the right side.
Access was gain then:The catheter was manipulated into the brachiocephalic trunk where a guiding injection confirmed common takeoff of the right and left common carotids. The catheter was then manipulated first towards the left where a semi-selective injection confirmed widely patent vessel and then to the right where there appeared to be a high-grade stenosis as noted on the CT angiograms of about 90% in severity.
A 6 mm Angiguard was then advanced into the right internal carotid near the siphon. With the Anioguard deployed in good position using primary stenting techniques, an 8 mm X 30 Precise stent was implanted covering the lesion stent nicely. The stent was post dilated with 6-mm aviator balloon taken all the way to 10 atmospheres. Repeat injection confirmed marked improvement with close to 0% residual at the initial treatment site with excellent positioning of the stent and good distal flow.
Conclusion:
Successful percutaneous revasculariztion of a tight stenosis of the right common carotid using PTA and stenting under Angioguard protection with 8 mm X 30 Precise stent implantation post, post dilated thru a 6-mm aviator balloon.
PROCEDURE:
1. Diagnostic-Selective carotid arteriography
2. PTA as well as stenting of a high-grade stenosis of the distal common carotid and proximal internal carotid on the right side.
Access was gain then:The catheter was manipulated into the brachiocephalic trunk where a guiding injection confirmed common takeoff of the right and left common carotids. The catheter was then manipulated first towards the left where a semi-selective injection confirmed widely patent vessel and then to the right where there appeared to be a high-grade stenosis as noted on the CT angiograms of about 90% in severity.
A 6 mm Angiguard was then advanced into the right internal carotid near the siphon. With the Anioguard deployed in good position using primary stenting techniques, an 8 mm X 30 Precise stent was implanted covering the lesion stent nicely. The stent was post dilated with 6-mm aviator balloon taken all the way to 10 atmospheres. Repeat injection confirmed marked improvement with close to 0% residual at the initial treatment site with excellent positioning of the stent and good distal flow.
Conclusion:
Successful percutaneous revasculariztion of a tight stenosis of the right common carotid using PTA and stenting under Angioguard protection with 8 mm X 30 Precise stent implantation post, post dilated thru a 6-mm aviator balloon.