PREOPERATIVE DIAGNOSIS: Left upper extremity arteriovenous fistula stenosis POSTOPERATIVE DIAGNOSIS: Left upper extremit

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PREOPERATIVE DIAGNOSIS: Left upper extremity
arteriovenous fistula stenosis POSTOPERATIVE DIAGNOSIS: Left upper
extremity arteriovenous fistula stenosis
PROCEDURE: 1. Left upper extremity fistulogram with
radiologic supervision and interpretation.
2. Balloon angioplasty of the left cephalic
vein
using an 8-mm x 40-mm balloon.
ANESTHESIA: Local
ESTIMATED BLOOD LOSS: Minimal
PROCEDURE: After informed consent was signed and placed
on the chart, the patient was taken to the imaging suite and
placed on the table in the supine position. The left upper
extremity was prepped and draped in the usual sterile fashion. We
began by anesthetizing the skin near the wrist using 1%
lidocaine.
The fistula was accessed in an antegrade manner with a
micro puncture needle. The micro wire was advanced and then
introducer sheath was placed over the wire. Initial imaging
was performed, which confirmed the area of stenosis. We then
advanced the Glidewire into the access and exchanged the
introducer sheath for a 6-French sheath. We then attempted to
cross through the lesion in an antegrade manner, this was not
successful. Therefore, at this point in time, we placed a 2-0
Prolene suture around the base of the sheath and the sheath
was removed without adequate hemostasis. We then accessed this
branch near the antecubital fossa in similar manner in a
retrograde fashion. Once we exchanged for a 6- French sheath, we
were able to easily cross in a retrograde manner through the
lesion. Angioplasty was then performed using the 8 mm x 40 mm
balloon.
At this point in time, following intervention, there was
no significant residual stenosis and the access once again
preferentially empties through this branch. Completion
imaging demonstrated no stenosis in the basilic, axillary,
subclavian, brachiocephalic, or superior vena cava. At this
point in time, it was determined that no further intervention will
be performed. Then, 2-0 Prolene suture was placed around the
base of the sheath, and the sheath was removed with adequate
hemostasis. The areas were both cleaned and dried, and
sterile dressings were applied. The patient tolerated the
procedure well. She remained stable throughout and was taken
to the recovery room in stable condition. Whats the ICD, CPT, HCPCS
Codes?