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Chemoembolization

Date: Oct 29, 2012

Question:

Please help code this one. INDICATIONS/COMMENTS: HCC/ HEPATIC CHEMOEMBOLIZATION RESULT: COMPARISON: 5/28/2012 HISTORY: 68-year-old male the history of and hepatocellular carcinoma. PROCEDURE: Chemoembolization. After obtaining informed consent patient placed in supine position on the angiographic table. The right groin was prepped and draped in the usual sterile fashioned. Ultrasound imaging of the common femoral artery was performed and access to the common femoral artery was obtained. A 19-gauge needle was inserted into the artery and ultrasound observation an 035 wire was advanced into the abdominal aorta. 5 French vascular sheath was placed at the arteriotomy site. Following this, Cobra 2 catheter was advanced into the abdominal aorta and used to select the origin of the celiac artery. Contrast was injected and images obtained. Due to the inferior course of the celiac artery, the Cobra catheter was exchanged for a Simmons 2 catheter. This catheter was placed in the origin of the celiac artery and advanced into the hepatic artery. Contrast was injected and images obtained. Following this, microcatheter was advanced coaxially through the catheter. The renegade high flow catheter and microwire were used to select the origin of the left hepatic artery. Chemoembolization was performed infusing approximately 20 mg of Doxorubicin on hepatic spheres. Antegrade flow was monitored throughout. The microcatheter was then pulled back into the main hepatic artery and advanced into the right hepatic artery. Only a small amount Doxorubicin was infused as the patient has a known portal vein occlusion. Antegrade flow was monitored continuously to ensure or the hepatic artery would not be compromised. Incidental note is made of vascular staining in the dome of the liver and in the posterior segment right lobe of the liver consistent with known tumors on CT.CONCLUSION: Limited chemoembolization of the left and right hepatic arteries as described above. A total of 60 mg of Doxorubicin on hepatis spheres was infused. Antegrade flow remained present throughout the procedure in both lobes of the liver. The star close device was used to achieve hemostasis at the right common femoral artery.. I have 75726, 75774, 36247, 36248, 37204, 75894, G0269, 75898. This is an inpatient in the hospital. thanks
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