Ask Dr. Z

Would you code as new graft or extensions? "The common femoral arteries were punctured bilaterally, and an 8 French sheath was followed by Prostar sutures and an 11 French sheath. We used pigtail catheters to advance through the Endologix AFX graft and avoid being in-snared in the 3 internal skeleton. After placing an Amplatz wire on the right side, a 16 French sheath was placed on the right. The pigtail was left on the left side. A 26 x 14 x 180 cm long C3 Excluder endograft was introduced from the right side and deployed below the renal arteries. The top end of the graft was in the middle to the top third of the suprarenal stent, which had migrated now below the renal arteries. The contralateral leg was cannulated with some difficulty from the left side because of tortuosity. The ipsilateral leg was completely deployed followed by an extension with a 20 x 10 to reach the iliac bifurcation on the right. On the left side, we placed a bridge of a 16 x 16 x 10 followed by a 20 x 14 contralateral leg down to the distal iliac artery."