I would love any thoughts on the correct way to code this op report!
The patient was brought to the endovascular suite. She was preped and draped in the usual sterile fashion. 1% lidocine used to anesthetize the left groin. There, a 6 French femoral arterial sheath was placed by Sledinger technique and contralateral access achieved using a rim catheter, Terumo Glidewire, Terumo glide catheter , and a SuperCore wire. A 7 French contralateral sheath was placed. Angiography revealed a patent right external and common femoral. The right superficial femoral artery had in-stent restenosis of approximately 80 percent, patent popliteal, and three vessel runoff. There was diffuse lesions in the posterior tibia. The anterior tibial and peroneal made it to the ankle. The posterior tibia made it to the ankle with a segment of diffuse disease of approximately 75 to 80 percent distally. The superficial femoral artery was wired using a 0.014 Spartacore wire. Heparin was given to maintain ACT greater than 250. A turbo tandem laser catheter was used to ablate plaque through the superficial femoral artery. Two passed were performed which reduced the stenosis to less than 50 percent. Balloon dilatation ws performed with a 5 X 120 VascuTRAK two balloon, relieving the stenosis to less than 10 percent.
Impression: Status post successful right superficial femoral artery in-stent restenosis atherectomy and angioplasty, using a Turbo tandem laser and a 5 X 120 VascuTRAK two balloon. No complications.
I am really confused and don't actually understane the in-stent restenosis! Any help would be appreciated.
Thanks,
Susan
The patient was brought to the endovascular suite. She was preped and draped in the usual sterile fashion. 1% lidocine used to anesthetize the left groin. There, a 6 French femoral arterial sheath was placed by Sledinger technique and contralateral access achieved using a rim catheter, Terumo Glidewire, Terumo glide catheter , and a SuperCore wire. A 7 French contralateral sheath was placed. Angiography revealed a patent right external and common femoral. The right superficial femoral artery had in-stent restenosis of approximately 80 percent, patent popliteal, and three vessel runoff. There was diffuse lesions in the posterior tibia. The anterior tibial and peroneal made it to the ankle. The posterior tibia made it to the ankle with a segment of diffuse disease of approximately 75 to 80 percent distally. The superficial femoral artery was wired using a 0.014 Spartacore wire. Heparin was given to maintain ACT greater than 250. A turbo tandem laser catheter was used to ablate plaque through the superficial femoral artery. Two passed were performed which reduced the stenosis to less than 50 percent. Balloon dilatation ws performed with a 5 X 120 VascuTRAK two balloon, relieving the stenosis to less than 10 percent.
Impression: Status post successful right superficial femoral artery in-stent restenosis atherectomy and angioplasty, using a Turbo tandem laser and a 5 X 120 VascuTRAK two balloon. No complications.
I am really confused and don't actually understane the in-stent restenosis! Any help would be appreciated.
Thanks,
Susan