Ask Dr. Z

Docs: Have you heard of anything like this? I came up with 75989-26?? Could this be an alcohol embolization 37204?? Appreciate your opinion! Arterial venous malformation right medial thigh. POSTOPERATIVE DIAGNOSIS: Arterial venous malformation right medial thigh. PROCEDURES: 1. Percutaneous drainage of a right thigh arteriovenous malformation. 2. Scleral therapy of right thigh arteriovenous confirmation with 98% alcohol. 3. Ultrasound-guided access to right thigh arteriovenous malformation. DRUGS GIVEN DURING THE CASE: 1. Versed 1 mg IV. 2. Fentanyl 50 mcg IV. 3. Distilled 98% alcohol 40 mL into the arteriovenous malformation. COMPLICATIONS: None. INDICATIONS: The patient is a very pleasant, but unfortunate, 52-year-old male. He has a very large arteriovenous malformation of the right medial thigh. Multiple attempts have been made to secure this. He underwent his first bout of sclerotherapy last week. PROCEDURE: On 08/05/2011, the patient was brought to the Interventional Suite. He was prepped and draped in sterile fashion. A timeout was made for safety. Using the ultrasound, I was able to guide an Angiocath catheter into the arteriovenous malformation. I directly visualized my needle entering the AVM under ultrasound. There is permanent record of this ultrasound in the chart. Once my catheter was in place I drained approximately 1 liter of blood from the arterial venous malformation. Once the arteriovenous malformation was appropriately drained, I instilled 40 mL of alcohol solution into the AVM. The catheter was removed.