Hello Mindy:

I have illustrated the 4 stents, thats of my thoughts

Quote Originally Posted by Shirleybala View Post

How many stents I have to code for the below report,confusing please help.

Aortogram, left lower extremity angiogram, iliac stenting and aortic
After obtaining informed consent, the patient was placed on the x-ray
table. Using ultrasound guidance, the left common femoral artery was
punctured and a 6 Fr. sheath was placed through a wire into the common
femoral artery. Angiogram revealed occlusion of the left common iliac
A wire was placed into the iliac artery but this appeared to be in a
false lumen.
The patient's right groin was prepped and draped in sterile fashion.
Using ultrasound guidance, the right common femoral artery was punctured
and a 6 Fr. sheath was placed into the common femoral artery. Through the
sheath, a 5 Fr. Omni I catheter was used to catheterize the aorta. A wire
was negotiated into the occluded left external iliac artery. From the
left sheath, the wire was snared and brought out of the patient by the
left side.
A catheter was then placed from the left sheath and a wire was placed
across the occluded segment of the left iliac artery into the aorta. A
wire was also placed from the right side into the aorta.
The decision was made to treat the occluded segment of the left common
iliac artery.
A balloon was placed into the right common iliac artery as protection and
a 8 mm-38 mm covered stent was then deployed in the left common iliac
(1st stent) Angiogram revealed excellent flow through the stent graft.
However, there is thrombus seen in the distal portion of the stent.
A 10 mm-25 mm stent was then placed into the external iliac artery (2nd stent)which
treated the stenosis adequately. There was a severe stenosis of the right
external iliac artery that was also treated with 8 mm-17 mm stent.
(3rd stent)Post stenting, an aortogram was performed. The aortogram revealed a large
plaque superior to the left common iliac stent.
The decision was made to place stents simultaneously into the iliac
Over wires, two 8 mm wallstents were placed into the aorta extending into
the iliac arteries bilaterally
(4th stent). Both stents were deployed simultaneously.
However, after the stents were deployed both stents migrated in a
cephalad manner into the aorta.
Multiple attempts were made to retrieve these stents but these were
The decision was then made to capture the stents via a 10 mm stents and 0
wires, two 10 mm-40 mm stent wall stent was then deployed into the
previously placed stent in the aorta and the aortic stent extending into
the iliac arteries. Post procedure, there is no residual gradient.
The patient's left lower extremity was evaluated and this showed an
occluded distal SFA. There was a short segment occlusion with
reconstitution of the popliteal artery. The popliteal artery is
continuous to the trifurcation and patient has a two vessel run-off.
IMPRESSION: Complete occlusion of the left iliac artery that was treated
with a covered stent.
However, and to treat the proximal portion of the stenosis the stents
migrated into the aorta and the entire distal aorta had to be structured
with stents.
Occluded distal left SFA.
Patent below the knee popliteal artery with a proximal run-off.