Ask Dr. Z

Can angio/stent be coded in addition to fem-pop bypass for these vessels? "A right fem-pop bypass graft was performed. An 8 mm PTFE graft was used, an arteriotomy was made in the common femoral artery, an end graft to side artery anastamosis was performed. An incision was made in the popliteal artery, an end graft to side artery anastamosis was created. On preop angio, a significant stenosis was noted in popliteal artery behind the knee and PT artery take off that would need intervention after the bypass to maintain above the knee target for better graft patency. Through the proximal graft, I accessed it with micro access needle for angiogram. The right external iliac artery and proximal anastomosis are patent with excellent flow. I turned the sheath around directed distally a RLE angio was performed, excellent flow through the bypass with patent distal anastomosis. The behind knee Popliteal artery has a moderate (60%) stenosis. He has 3 vessel run off via the peroneal and ATA and PTA arteries. But there is an 80% orificial PT artery stenosis. PTA balloon of the popliteal and PT arteries were made with resolution of stenosis."