How would you code this report as tips revision or an embolization, Please advise?
Ultrasound evaluation ther right neck demonstrated the right jugular vien to be patent compressable and suitable for venous access. An image was obtained and saved. Under direct ultrasound visualization the right jugular vein was accessed and a 7 French sheath placed. Through this a C2 catheter was negotiated all the way
down into the IVC and through the TIPS shunt. Hand injection of a few cc of diluted Visipaque 320 demonstrated good flow through the TIPS shunt. A full venogram venogram was not performed due to the patient renal failure. Next a 14mm Amplatz II
plug was deployed in the covered portion of the TIPS stent.
After a few minutes, injection of contrast through the
sheathdemonstrated no further antegrade flow through the TIPS shunt.
The catheter was withdrawn and hemostasis obtained at the puncture
site. The patient tolerated the procedure well.
A total of 20 cc of Visipaque 320 was used for the procedure.
IMPRESSION:
TIPS SHUNT OCCLUDED WITH AN AMPLATZ II PLUG.
Ultrasound evaluation ther right neck demonstrated the right jugular vien to be patent compressable and suitable for venous access. An image was obtained and saved. Under direct ultrasound visualization the right jugular vein was accessed and a 7 French sheath placed. Through this a C2 catheter was negotiated all the way
down into the IVC and through the TIPS shunt. Hand injection of a few cc of diluted Visipaque 320 demonstrated good flow through the TIPS shunt. A full venogram venogram was not performed due to the patient renal failure. Next a 14mm Amplatz II
plug was deployed in the covered portion of the TIPS stent.
After a few minutes, injection of contrast through the
sheathdemonstrated no further antegrade flow through the TIPS shunt.
The catheter was withdrawn and hemostasis obtained at the puncture
site. The patient tolerated the procedure well.
A total of 20 cc of Visipaque 320 was used for the procedure.
IMPRESSION:
TIPS SHUNT OCCLUDED WITH AN AMPLATZ II PLUG.