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Pt w/peritoneal carcinomatosis. With fluoro guidance, an angled glide catheter and stiff Glidewire were advanced thru the nose and into the stomach. A 24mm x 4cm angioplasty balloon was advanced into the esophagus over the guidewire. The balloon was inflated and US of the left neck showed a safe window of access for percutaneous transesophageal gastrostomy between the thyroid gland and LT carotid. With US guidance, an 18-g trocar needle was advanced between the thyroid gland and LT carotid. The needle was used to puncture the angioplasty balloon. Through the needle a J-wire was advanced/coiled within the angioplasty balloon. A 2nd operator then advanced the angioplasty balloon and wire into the stomach. Once in the stomach, the wire was separated from the angio balloon and the balloon was removed. Over the wire, after serial dilatation, a 12Fr x 60cm drainage catheter was advanced. The pigtail portion was formed within the stomach. Position was confirmed with contrast and catheter was secured to the skin. 

Would this be 49440 or unlisted 43999?