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would you do 37220 and 37224 for this one? PROCEDURE IN DETAIL: The patient was brought to the Angio Suite and placed in supine position. After a time-out was performed, the bilateral groins were prepped and draped in sterile fashion. Ultrasound guided access was attempted in the right common femoral artery. However, we could not advance the wire. The patient did have a known external iliac artery stenosis. However, despite multiple attempts, we could not get the wire to traverse proximally. In order to treat the left external iliac artery and superficial femoral artery occlusive disease, I needed to establish access from the left brachial artery. This was performed under ultrasound guidance with a micropuncture kit. A 5 French sheath was ultimately placed and the 90 cm pigtail catheter placed in the distal infrarenal abdominal aorta. Aortoiliac angiogram should distal external iliac artery occlusive disease bilaterally as was depicted on the arterial duplex. The 0.035 angle tip stiff glidewire was then used to carefully select the left common iliac, common external iliac and common femoral artery. The short 5 French sheath was exchanged for a 90 cm 6 French sheath with the tip positioned in the left iliac system. Iliac and left lower extremity arteriogram was then performed to the extent of the knee due to the reach of the table from the brachial position. There was approximately 60-70% stenosis of the left external iliac artery and occlusion and approximately 20 cm occlusion in the left superficial femoral artery. I was able to traverse the external iliac artery stenosis as well as the superficial femoral artery occlusion to the mid thigh. However, this was the extent of the length of the balloon at 135 cm. A 5 mm x 10 cm balloon was then used to angioplasty the origin of the left superficial femoral artery as well as the upper third of the superficial femoral artery into the mid thigh. I did over-inflate this balloon to angioplasty the left external iliac artery with good results. Completion arteriography showed excellent flow through the proximal superficial femoral artery and the known residual distal stenosis which we could not reach from the arm. There was reconstitution of the above knee popliteal artery which continues relatively disease free below the knee. The trifurcation shows only runoff through the peroneal artery. A total of 58 ml of contrast was utilized. The 90 cm 6 French sheath was exchanged for a short 6 French sheath to be removed once the ACT was less than 175 seconds. I was present the entire portion of the procedure.