Shirleybala
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History: 55-year-old with going right retroperitoneal hematoma
status-post embolization of the active bleed in the distribution
of the right renal artery presents with apparent recurrent
bleeding.
Procedure and findings: After obtaining informed consent,
anesthesia was established by the anesthesiologist. Continuous
physiologic monitoring of arterial blood pressure, pulse and
oxygen saturation was performed throughout the the procedure.
The patient was placed supine on the fluoroscopic table and the
right groin region was prepped and draped in a sterile fashion.
The right common femoral artery was accessed via Seldinger
technique, and a 5-French angiographic sheath was placed for
vascular access. A 5 French SOS selective catheter was used to
catheterize the right renal artery. Selective angiography with the
catheter positioned in the origin of the right renal artery
demonstrated opacification of the upper pole of the right kidney.
No active extravasation was demonstrated. Using coaxial technique
a 3 French micro-catheter was advanced into the distal right renal
artery. Angiography demonstrated no active extravasation in the
distribution of the terminal branches of the right renal artery in
the vicinity of the in situ percutaneous nephrostomy where coil
embolization was performed previously. Subsequently, selective and
subselective catheterizations of the second renal artery supplying
the lower pole, T12 intercostal artery, L1 lumbar artery, L2
lumbar artery, L2 lumbar artery, phrenic artery, capsular artery,
bilateral internal iliac arteries were performed. No active
extravasation was demonstrated in the distributions of the above
arteries. No embolization was performed. The sheath was removed
followed by manual compression until hemostasis.
IMPRESSION:
No active extravasation was demonstrated by subselective
angiography of the upper pole right renal artery, lower pole renal
artery, T12 intercostal artery, L1 lumbar artery, L2 lumbar
artery, L2 lumbar artery, phrenic artery, capsular artery,
bilateral internal iliac arteries.
No embolization was performed.
History: 55-year-old with going right retroperitoneal hematoma
status-post embolization of the active bleed in the distribution
of the right renal artery presents with apparent recurrent
bleeding.
Procedure and findings: After obtaining informed consent,
anesthesia was established by the anesthesiologist. Continuous
physiologic monitoring of arterial blood pressure, pulse and
oxygen saturation was performed throughout the the procedure.
The patient was placed supine on the fluoroscopic table and the
right groin region was prepped and draped in a sterile fashion.
The right common femoral artery was accessed via Seldinger
technique, and a 5-French angiographic sheath was placed for
vascular access. A 5 French SOS selective catheter was used to
catheterize the right renal artery. Selective angiography with the
catheter positioned in the origin of the right renal artery
demonstrated opacification of the upper pole of the right kidney.
No active extravasation was demonstrated. Using coaxial technique
a 3 French micro-catheter was advanced into the distal right renal
artery. Angiography demonstrated no active extravasation in the
distribution of the terminal branches of the right renal artery in
the vicinity of the in situ percutaneous nephrostomy where coil
embolization was performed previously. Subsequently, selective and
subselective catheterizations of the second renal artery supplying
the lower pole, T12 intercostal artery, L1 lumbar artery, L2
lumbar artery, L2 lumbar artery, phrenic artery, capsular artery,
bilateral internal iliac arteries were performed. No active
extravasation was demonstrated in the distributions of the above
arteries. No embolization was performed. The sheath was removed
followed by manual compression until hemostasis.
IMPRESSION:
No active extravasation was demonstrated by subselective
angiography of the upper pole right renal artery, lower pole renal
artery, T12 intercostal artery, L1 lumbar artery, L2 lumbar
artery, L2 lumbar artery, phrenic artery, capsular artery,
bilateral internal iliac arteries.
No embolization was performed.