Procedure Perfomed: Endovascular Aortic Aneurysm Repair using an Endologix device.
Desc of procdeure: Under general anesthesia, an incision was made in the groin and carried down to soft tissue. The common, superficial and profunda femoris vessels were identified on the right. Percutaneous access was obtained to the common femoral on the left and an 8-French sheath was placed in position there and a wire was advanced into the central circulation on that side. A 6-French introducer was introduced on the right side and a lunderquist wire was advanced up to the arch. Subsequently a main body 25 x 80 with 16 x 4 limbs advanced up the ipsilateral wire into the aorta. The buddy wire was advanced up. It was snared and brought down on the contralateral side. The entire device was advanced in to the aorta. The main body was then exposed. The pt had been systemically heparinized with 5000 units of heparin prior to the placement of the main body. The main body itself was brought down upon the bifurcation and deployed. The ipsilateral limb was then deployed through the contralateral wire. An 014 wire was advanced into the central circulation and the left limb was deployed again with difficulty. Arteriogram was performed at this time which demonstrated that the aneurysm itself had been covered although the graft did not extend up to the level of the renals. The approx reason for placing the graft was to prevent further atheroembolization and because of the angulation present I did not fee it was well warranted to continue to extend up past the neck of the aneurysm. There was good flow in the renals as well as some hyper______ vessels. No typeI, II, III or IV endoleak. Subsequently the right iliac limb was dilated with a 10 mm balloon to assure its full deployment. On the contralateral side the site was closed with an 8-Frenc h angio-seal. On the ipsilateral side the sheath was removed and the artery was then closed transversely in a standard manner using 6-0 prolene. Was wound was irrigated and closed with Vicryl, Monocryl and steri-strips.
I am a new at coding endovascular and really need so help with this one. Thank you
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