AshleyMartin
Networker
Please help me code this correctly:
The patient was prepped and draped in sterile fashion. Access was obtained by the left femoral vein via the modified Seldinger technique after 1% lidocaine was used to anesthetize the area. A 6-French sheath was palced and the left femoral vein, flushed without any complications. We introduced a 6-French angled pigtail catheter over a 0.35 J-wire. We were able to advance this into the pulmonary artery. Angiography of the main pulmonary trunks and both right and left lobes were taken. Main embolus in the trunk had fragmented and gone into the lobes. We then proceeded with IVC filter placement. A venogram was performed through the trapeze sheath. Cordis IVC filter was then placed. All equiptment was then removed and hemostasis was achieved using manual pressure. The pateint tolerated the procedure well. There were no complications.
Findings:
1. Both main pulmonary arteries are free of clot. There is diffuse clot extending into the intralobar arteries bilaterally.
2. Inferior vena cava is appropriate in size. Both renal veins were visualized.
Conclusions:
1. Pulmonary embolus
2. Status post pulmonary angiography showing dissolution of the saddle embolus.
3. Successful IVC filter placement.
Thanks!
The patient was prepped and draped in sterile fashion. Access was obtained by the left femoral vein via the modified Seldinger technique after 1% lidocaine was used to anesthetize the area. A 6-French sheath was palced and the left femoral vein, flushed without any complications. We introduced a 6-French angled pigtail catheter over a 0.35 J-wire. We were able to advance this into the pulmonary artery. Angiography of the main pulmonary trunks and both right and left lobes were taken. Main embolus in the trunk had fragmented and gone into the lobes. We then proceeded with IVC filter placement. A venogram was performed through the trapeze sheath. Cordis IVC filter was then placed. All equiptment was then removed and hemostasis was achieved using manual pressure. The pateint tolerated the procedure well. There were no complications.
Findings:
1. Both main pulmonary arteries are free of clot. There is diffuse clot extending into the intralobar arteries bilaterally.
2. Inferior vena cava is appropriate in size. Both renal veins were visualized.
Conclusions:
1. Pulmonary embolus
2. Status post pulmonary angiography showing dissolution of the saddle embolus.
3. Successful IVC filter placement.
Thanks!