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TIPS Constraint

Date: Jan 21, 2019

Question:

Would you code this as revision or what? "The 7 French sheath catheter pigtail was exchanged for an Xtra Sport wire over which a 7 mm x 16 mm Formula stent was placed and advanced to the mid TIPS. The pigtail through the 10 French sheath was exchanged for an Amplatz, and the sheath was advanced through the existing TIPS. A new 10 x 7 x 2 TIPS was deployed in line with the existing TIPS and postdilated with a 10 mm x 4 cm Dorado balloon. The 7 mm x 16 mm Formula stent was then deployed at the midportion of the TIPS and inflated to maximal pressure (12 atm; 7.27 mm). Post-constraint portal venogram demonstrated expected decreased flow through the TIPS with increased flow through intrahepatic portal vein branches. Post constraint portosystemic pressure gradient was 12 mmHg.  The catheters and sheath were removed and hemostasis was obtained with manual compression. TIPS device: Gore Viatorr TIPS type: Covered."

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