lisammy
Guru
One of my surgeons put a filter in the SVC. Was wondering what you would use for this. 37620 specifically says inferior vena cava.
Thanks for you help
Thanks for you help
HERE IS A COPY OF THE REPORT FOR YOU TO SHARE. THANKS FOR YOUR INPUT.
POSTOPERATIVE DIAGNOSIS: Right upper extremity deep vein thrombosis and inability to anticoagulate.
PROCEDURE:
1. Ultrasound guidance of percutaneous access.
2. Superior venacavogram with Radiological supervision and interpretation.
3. Insertion of superior vena cava filter (Celect IJ).
COMPLICATIONS: None.
APPROACH: Right common femoral vein - retrograde.
CLINICAL HISTORY: female who had a subdural hematoma status post evacuation a couple of weeks ago. She has developed right upper extremity DVT which has propagated last week. She has a history of thrombus in her left IJ as well. Now both internal jugular veins are occluded as well as her right axillary vein. I was asked to place a filter for inability to anticoagulate.
TECHNIQUE: The patient was brought to The Catheterization Suite and placed in the supine position. After adequate anesthesia was obtained, the patient was prepped and draped in the usual sterile fashion. The right common femoral artery was palpated and the skin medial to this was infiltrated with 1% Xylocaine. Under ultrasound guidance, the right common femoral vein was punctured in a retrograde manner with an introducer needle followed by an 0.35 Bentson Wire which was advanced up into the superior vena cava. The introducer needle was removed and a Celect IJ Filter, Sheath, and Dilator were advanced to the superior vena cava. The wire and dilator were removed. Superior venacavogram was performed to make sure no thrombus.
VENOGRAPHIC FINDINGS: The superior vena cava is widely patent with no signs of thrombus. The innominate veins are identified and patent bilaterally.
A Celect IJ Filter was then placed through the sheath with the tines placed facing up to collect any clot. The sheath was then pulled back and the filter deployed in the SVC. A post deployment picture revealed it to be in excellent position. The sheath was then removed and hemostasis obtained in the groin with pressure. The patient tolerated the procedure well. She was taken to her room in good condition.