Misty Dawn
Guru
This is my weak area so I am hoping someone can look at these lower extrem study and let me know if I am on the right track or what I am misisng. Thank you very much for your help!!
DESCRIPTION OF PROCEDURE:
Informed consent was obtained from the patient, the risks, benefit, alternatives, and possible complications were discussed with the patient who was agreeable and wished to proceed, and a time-out was performed to verify the patient's identification and planned procedure. He has an allergy to IV iodine, and was pretreated with 100 mg of IV Solu-Cortef and 50 mg of IV Benadryl. The patient's left groin was then prepped and draped in the usual sterile fashion, and anesthetized with 1% Lidocaine. A 5 French sheath was placed in the left femoral artery using a modified Seldinger technique. Initial access was obtained using a 5 French micro access system. A 5 French pigtail catheter was advanced into the abdominal aorta , and was positioned above the level of the takeoff of the right and left iliac arteries. Bilateral iliac angiography was performed using digital subtraction angiography with an injection rate of 15 cc per second for a total dose of 30 cc. Following this, intravascular ultrasound was used to assess the right and left common iliac arteries as well as the right and left external iliac arteries and right and left common femoral arteries. 4000 units of intravenous heparin were given. A 5 French Rim catheter was advanced to the aortoiliac bifurcation and was used to selectively engage the right common iliac artery. A 0.014 with a wire was advanced through the right common femoral artery into the right superficial femoral artery. Intravascular ultrasound assessment of the right and left common iliac arteries, right and left external iliac arteries, and right and left common femoral arteries was then performed. Following the procedure, the sheath was sutured in place, and the patient was transferred back to the postprocedure recovery area in satisfactory condition. A total of 30 cc of IV contrast was used for the procedure. The findings are as follows:
FINDINGS:
The distal infrarenal abdominal aorta is ectatic. The previous stents in the right common and right external iliac artery remain patent. There is a 50% in-stent restenosis in the distal portion of the right common iliac artery, and a 50% stenosis in the mid to distal section of the right external iliac artery. The right common femoral artery has a 40-50% stenosis. The previous stents in the left common and left external iliac artery remain patent. There is a 50% stenosis in the distal left common iliac artery, and a 50% stenosis in the distal left external iliac artery.
CONCLUSIONS:
1. Patent stents in the right and left common iliac arteries and right and left external iliac arteries; focal 50% in-stent restenoses are seen in the distal portion of the right and left common iliac arteries, as well as in the mid to distal portion of the right and left external iliac arteries.
2. 50% right common femoral artery stenosis.
36247, 37250, 37251-59, 37251-59, 37251, 75716, 75945-26, 75946-26-59, 75946-26-59, 75946-26 .
Thanks, Misty
DESCRIPTION OF PROCEDURE:
Informed consent was obtained from the patient, the risks, benefit, alternatives, and possible complications were discussed with the patient who was agreeable and wished to proceed, and a time-out was performed to verify the patient's identification and planned procedure. He has an allergy to IV iodine, and was pretreated with 100 mg of IV Solu-Cortef and 50 mg of IV Benadryl. The patient's left groin was then prepped and draped in the usual sterile fashion, and anesthetized with 1% Lidocaine. A 5 French sheath was placed in the left femoral artery using a modified Seldinger technique. Initial access was obtained using a 5 French micro access system. A 5 French pigtail catheter was advanced into the abdominal aorta , and was positioned above the level of the takeoff of the right and left iliac arteries. Bilateral iliac angiography was performed using digital subtraction angiography with an injection rate of 15 cc per second for a total dose of 30 cc. Following this, intravascular ultrasound was used to assess the right and left common iliac arteries as well as the right and left external iliac arteries and right and left common femoral arteries. 4000 units of intravenous heparin were given. A 5 French Rim catheter was advanced to the aortoiliac bifurcation and was used to selectively engage the right common iliac artery. A 0.014 with a wire was advanced through the right common femoral artery into the right superficial femoral artery. Intravascular ultrasound assessment of the right and left common iliac arteries, right and left external iliac arteries, and right and left common femoral arteries was then performed. Following the procedure, the sheath was sutured in place, and the patient was transferred back to the postprocedure recovery area in satisfactory condition. A total of 30 cc of IV contrast was used for the procedure. The findings are as follows:
FINDINGS:
The distal infrarenal abdominal aorta is ectatic. The previous stents in the right common and right external iliac artery remain patent. There is a 50% in-stent restenosis in the distal portion of the right common iliac artery, and a 50% stenosis in the mid to distal section of the right external iliac artery. The right common femoral artery has a 40-50% stenosis. The previous stents in the left common and left external iliac artery remain patent. There is a 50% stenosis in the distal left common iliac artery, and a 50% stenosis in the distal left external iliac artery.
CONCLUSIONS:
1. Patent stents in the right and left common iliac arteries and right and left external iliac arteries; focal 50% in-stent restenoses are seen in the distal portion of the right and left common iliac arteries, as well as in the mid to distal portion of the right and left external iliac arteries.
2. 50% right common femoral artery stenosis.
36247, 37250, 37251-59, 37251-59, 37251, 75716, 75945-26, 75946-26-59, 75946-26-59, 75946-26 .
Thanks, Misty