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Redo TCAR with balloon angioplasty of stent, embolic protection device

Date: Sep 2, 2022

Question:

Should this be reported with 37215-78-52 or 37246-GZ?

"Poor expansion of the right internal carotid stent was likely an embolic event. After extensive workup and anticoagulation and antiplatelet regimen instituted, the consensus opinion was had, and repeat TCAR with ballooning of this poorly expanded stent would be immediately helpful as well as for long-range stent durability and patency. Left common femoral vein access had been obtained with ultrasound guidance, and this was upsized to 8 French silk sheath. We then initiated passive flow reversal checking for excellent flow, then clamped the common carotid artery proximal to the sheath to allow for active flow reversal. We performed angiography in two views, and stent was then decompressed and inadequately expanded, used first-day #5 and then a 6 x 40 mm balloon for re-angioplasty with full flow reversal." 

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