NancyZ76
Contributor
Anyone one willing to take a look and help me out please.
I'm thinking 36222-50 and 75650
PROCEDURE:
1. Percutaneous right common femoral artery access with ultrasound guidance.
2. Cannulation of aortic arch.
3. Arteriogram of aortic arch.
4. Selective cannulation of right common carotid artery.
5. Angiogram of right common carotid artery.
6. Selective cannulation of left common carotid artery.
7. Angiogram of left common carotid artery.
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.
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DESCRIPTION OF PROCEDURE:
Patient was taken to the angiography suite and placed in a supine position. Mild sedation was given and the groins were prepped and draped in a sterile manner. 1% lidocaine was used to infiltrate the surgical area. Percutaneously, the right common femoral artery was accessed under direct ultrasound guidance. A guidewire was inserted under fluoroscopy. Over the guidewire, a 5-French introducer was placed. Over the guidewire into the introducer a 5-French pigtail catheter was inserted and guided to the proximal aortic arch. An angiogram was performed of the arch. Once angiogram was performed, the pigtail catheter was removed and was exchanged to a Vitek catheter over a Glidewire. Selectively the right common carotid artery was accessed and the catheter was advanced into the right common carotid artery. From this position an angiogram of the right carotid artery was done. The guidewire was reinserted and the catheter was backed out into the arch and selective cannulation of the left common carotid artery was performed and the catheter was advanced into the left common carotid artery. From this position an angiogram was performed of the left system. During the angiogram of the left and the right common carotid arteries, multiple views were taken including oblique view and AP and lateral views. The catheter was then removed and the introducer was removed. Hemostasis was obtained by direct pressure for 20 minutes. Dressings were placed and the patient was then transferred to the recovery room stable. No complication was seen. The estimated blood loss was minimal.
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FINDINGS:
The patient was seen to have a normal aortic arch with the great vessels. There were no abnormalities and stenosis.
*
On the right side, the common carotid artery was widely patent along with the external carotid artery. The internal carotid artery shows atherosclerotic changes at its origin and after reviewing several views there is no hemodynamically significant narrowing.
*
On the left side, the common carotid artery is widely patent. The internal carotid artery itself shows mild disease with narrowing of approximately 15-20%. The external carotid artery, however, has a high-grade stenosis of greater than 90%, short segment at its origin.
*
At this time, the patient will follow up in the office for further consultation and discussion of the findings as well as future management plans.
*
I'm thinking 36222-50 and 75650
PROCEDURE:
1. Percutaneous right common femoral artery access with ultrasound guidance.
2. Cannulation of aortic arch.
3. Arteriogram of aortic arch.
4. Selective cannulation of right common carotid artery.
5. Angiogram of right common carotid artery.
6. Selective cannulation of left common carotid artery.
7. Angiogram of left common carotid artery.
*
.
*
DESCRIPTION OF PROCEDURE:
Patient was taken to the angiography suite and placed in a supine position. Mild sedation was given and the groins were prepped and draped in a sterile manner. 1% lidocaine was used to infiltrate the surgical area. Percutaneously, the right common femoral artery was accessed under direct ultrasound guidance. A guidewire was inserted under fluoroscopy. Over the guidewire, a 5-French introducer was placed. Over the guidewire into the introducer a 5-French pigtail catheter was inserted and guided to the proximal aortic arch. An angiogram was performed of the arch. Once angiogram was performed, the pigtail catheter was removed and was exchanged to a Vitek catheter over a Glidewire. Selectively the right common carotid artery was accessed and the catheter was advanced into the right common carotid artery. From this position an angiogram of the right carotid artery was done. The guidewire was reinserted and the catheter was backed out into the arch and selective cannulation of the left common carotid artery was performed and the catheter was advanced into the left common carotid artery. From this position an angiogram was performed of the left system. During the angiogram of the left and the right common carotid arteries, multiple views were taken including oblique view and AP and lateral views. The catheter was then removed and the introducer was removed. Hemostasis was obtained by direct pressure for 20 minutes. Dressings were placed and the patient was then transferred to the recovery room stable. No complication was seen. The estimated blood loss was minimal.
*
FINDINGS:
The patient was seen to have a normal aortic arch with the great vessels. There were no abnormalities and stenosis.
*
On the right side, the common carotid artery was widely patent along with the external carotid artery. The internal carotid artery shows atherosclerotic changes at its origin and after reviewing several views there is no hemodynamically significant narrowing.
*
On the left side, the common carotid artery is widely patent. The internal carotid artery itself shows mild disease with narrowing of approximately 15-20%. The external carotid artery, however, has a high-grade stenosis of greater than 90%, short segment at its origin.
*
At this time, the patient will follow up in the office for further consultation and discussion of the findings as well as future management plans.
*