vendredi 28 août 2015

Tunneled line via superficial vein

How would you code this?
A tunneled line via superficial femoral vein?
PROCEDURE: LEFT FEMORAL DOUBLE LUMEN TUNNELED CENTRAL LINE
PLACEMENT


PROCEDURE: A limited ultrasound of the left groin was performed
to choose a site for insertion of the central line. The left
superficial femoral vein was chosen, and the skin of the left
thigh was prepped and draped in sterile fashion. Using real-time
ultrasound guidance, the left superficial femoral vein was
tunnel punctured with a 21g needle from the mid thigh via a
subcutaneous tunnel into the left superficial femoral vein near
the confluence with the greater saphenous vein at the groin. Once
venous blood was obtained an 0.014" hydrophilic wire was placed
into the vein and advanced to the central inferior vena cava. A
small dermatotomy was made and the 3 Fr peel-away sheath was
advanced into the vein. The distance to the cavo-atrial junction
was measured with fluoroscopy and guidewire subtraction technique
and a 2.6 F double lumen central line was cut to 15 cm. Via the
tunnel, the central line was placed into the vein and advanced
with fluoroscopic guidance until the tip was at the inferior
cavoatrial junction. The catheter was fixed to the skin with a
Stat-Lock device in the mid thigh, affixed to the device with
steri-strips, surgicel, gauze and tegaderms. The catheter
aspirated and flushed easily and was heparinized with 10 U of
heparin from a 1mL:10U dilution preparation in each lumen. The
patient left the IR suite in stable condition. Duskiness of the
left lower extremity was appreciated and pointed out to Dr
, Dr. was present for the entire procedure.

FINDINGS: A limited ultrasound of the left groin showed patent
left superficial femoral and common femoral veins. Fluoroscopic
spot image of the appropriately positioned central line at the
inferior cavoatrial junction was obtained and stored in the PACS
system.

IMPRESSION
Successful placement of a 15 cm, 2.6F double lumen
tunneled central line via the left superficial femoral vein with
tip at the inferior cavoatrial junction.


Tunneled line via superficial vein

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