Is this just 36870 or is there more to this than what I am seeing?
After IV sedation was given, we prepped and draped the left upper extremity. After that we thoroughly infiltrated with 1% lidocaine local to level to the above incision. We identified the graft easily. This was controlled with a vessel. We then heparinized the patient and then proceeded treating the graftotomy in a transverse fashion. Using a 5-mm embolectomy to remove thrombus and found excellent backbleeding of the venous out flow. Several areas were ballooned and opened. We then turned out attention towards brachial artery anastomosis and this was easily crossed using an embolectomy catheter. We retrieved fair amount of thrombus until excellent inflow was obtained. The thrombus was removed. We repaired the graftotomy with a 6-0 prolene 2- layer closure for hemostasis. There was a thrill and audible bruit within the graft after completion. After satisfactory hemostatis, we irrigated with saline, proceeded to close the deep fascia with 3-0 vicryl, followed by subcuticular 4-0 vicryl suture. Dry, sterile dressing were applied. All counts were correct at the end of the case.
Thank you,
Brendan Bailey, CPC
After IV sedation was given, we prepped and draped the left upper extremity. After that we thoroughly infiltrated with 1% lidocaine local to level to the above incision. We identified the graft easily. This was controlled with a vessel. We then heparinized the patient and then proceeded treating the graftotomy in a transverse fashion. Using a 5-mm embolectomy to remove thrombus and found excellent backbleeding of the venous out flow. Several areas were ballooned and opened. We then turned out attention towards brachial artery anastomosis and this was easily crossed using an embolectomy catheter. We retrieved fair amount of thrombus until excellent inflow was obtained. The thrombus was removed. We repaired the graftotomy with a 6-0 prolene 2- layer closure for hemostasis. There was a thrill and audible bruit within the graft after completion. After satisfactory hemostatis, we irrigated with saline, proceeded to close the deep fascia with 3-0 vicryl, followed by subcuticular 4-0 vicryl suture. Dry, sterile dressing were applied. All counts were correct at the end of the case.
Thank you,
Brendan Bailey, CPC