mdawn
New
Hello, I am having a hard time coding this one and my co-workers aren't sure either. Any suggestions would be greatly appreciated!
Reason for exam:
SHEATH INSERTION FOR DIALYSIS
REPORT:
Recent malfunctioning of fistula right arm with 2 recent episodes of declotting and viabahn stent insertion. Venous access is recommended prior to dialysis for the next few weeks.
APPROACH: RUNOFF VEIN RIGHT UPPER FOREARM
ULTRASOUND GUIDANCE. CATHETER: TWO 6 FRENCH VASCULAR SHEATHS
PROCEDURE:
Following local anesthesia and utilizing maximal sterile barrier technique, the vein listed above was punctured with a micropuncture needle, utilizing ultrasound guidance a sonographic image was obtained for confirmation of needle position and vessel patency. A .018 wire was passed through this needle, followed by insertion of a 4 French dilator. The 018 wire was then exchanged for an 035 j-wire, followed by insertion of a 6 French vascular sheath. This was performed twice in the same vein, with insertion of 2 sheaths, both rectus cephalad. The hubs of the sheaths were then stabilized to the skin with a sterile opsite dressing. The patient was sent for dialysis.
Status post successful venous sheath insertion for dialysis.
Reason for exam:
SHEATH INSERTION FOR DIALYSIS
REPORT:
Recent malfunctioning of fistula right arm with 2 recent episodes of declotting and viabahn stent insertion. Venous access is recommended prior to dialysis for the next few weeks.
APPROACH: RUNOFF VEIN RIGHT UPPER FOREARM
ULTRASOUND GUIDANCE. CATHETER: TWO 6 FRENCH VASCULAR SHEATHS
PROCEDURE:
Following local anesthesia and utilizing maximal sterile barrier technique, the vein listed above was punctured with a micropuncture needle, utilizing ultrasound guidance a sonographic image was obtained for confirmation of needle position and vessel patency. A .018 wire was passed through this needle, followed by insertion of a 4 French dilator. The 018 wire was then exchanged for an 035 j-wire, followed by insertion of a 6 French vascular sheath. This was performed twice in the same vein, with insertion of 2 sheaths, both rectus cephalad. The hubs of the sheaths were then stabilized to the skin with a sterile opsite dressing. The patient was sent for dialysis.
Status post successful venous sheath insertion for dialysis.