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Multiple angiolasty and stent placement

Date: Sep 22, 2010

Question:

Dr Z can you help with this case?? The Doctors notes a type 3 aortic arch. He punctures the right common femoral artery in a retrograde direction, he goes up and does an arch angiogram. He then selectively catheterizes the left sublclavian artery. Additional images of the left subclavian artery are obtained. He then selectively caths the left subclavian artery distally and was able to advance a sheath over a stiff wire into the left subclavian artery. The shuttle sheath was advanced distal to the left vertebral artery and a atrium stent was deployed in the distal subclavian lesion. This was post dialated with a balloon to a more acceptable caliber across the lesion. He then places a genesis stent within the sheath and pulls the sheath back to the origin of the left subclavian artery where another stent was deployed across the origin of the artery. He then removes the catheters and wires from the left subclavian position and pulled down to the abdominal aorta. Additional images of the right iliac system where obtained and this demonstrated a very significant external iliac artery lesion of approx. 70% and a common iliac artery multifocal calcified lesion. He then does an angioplasy of the external and common iliac arteries with significant recoil. A Smart stent was deployed across the lesion and this stent was postdilated with a balloon. He then goes on to deploy a closure device. Can you help me code this?? Thanks

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