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Aortic Arch Aortogram

Date: May 23, 2014

Question:

I have an aortic arch aortogram that was done.  I have been coding 36221 and 75625, but my case was done from a left arm approach. Here is the report:

Procedure Description: The right radial artery was cannulated. The right brachial artery is occluded. An attempt to traverse a large collateral branch was unsuccessful. The left radial artery was cannulated. Catheters and various guidewires could not be manipulated into the ascending aorta, although the guidewires readily prolapsed back up the innominate artery. Biplane aortic arch angiography was performed, and the procedure was then terminated. Aortic arch: The catheter enters the aortic arch from a left arm approach. There is a linear impediment to flow and passage of the catheter from the arch into the ascending aorta, except for a very small communication at the postero-medial edge of the barrier. With injection into the arch, there is excellent opacification of the three brachiocephalic vessels and RIMA, and only faint penetration of contrast down the descending thoracic aorta.

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