Thank you my Ladies I so needed the input I go tomorrow to see what this doctor has to say I know I HAVE MEDICARE AND MEDICAID insurance hoping I have no problems with them ? i feel to fo to mayo in Minnesota only 6 hrs away this is the results if anyone knows what this means love your inputs This is my test results Study Result

PROCEDURE: CTA ABDOMINAL AORTA BIFEM DIA-MID FEM (IV) MEASURE (CPT=75635)

COMPARISON: None.

INDICATIONS: I73.9 Peripheral vascular disease, unspecified. Patient states she has occluded iliac stents.

TECHNIQUE: After obtaining the patient's consent, CT images of the abdomen, pelvis, and lower extremities were obtained pre- and post- injection of non-ionic intravenous contrast material. Multi-planar reformatted/3-D images were created to optimize
visualization of vascular anatomy. Dose reduction techniques were used.

CONTRAST USED: 100 cc of non-ionic contrast

FINDINGS:
AORTO-ILIAC: Patient status post bilateral common iliac and external iliac stents as well as left main renal artery stent. The left main renal artery stent appears chronically occluded. There is marked atrophy of the left native kidney. No appreciable
contrast opacifying the distal abdominal aorta just proximal to the aortic bifurcation. The common iliac stents appear occluded bilaterally. The right external iliac stent is occluded. There is opacification of the very distal left external iliac stent.
There is reconstitution of the common femoral arteries bilaterally secondary to collateral vessels. Moderate to severe calcified atheromatous plaque involving the abdominal aorta. The origin of the celiac is widely patent. There is mild to moderate
plaque at the origin of the SMA which is diminutive in caliber with suggestion of greater than 50% narrowing of the proximal SMA. Mild calcific plaque involving the origin of the right main renal artery with moderate plaque involving the proximal right
main renal artery. The IMA is not seen to opacify off the abdominal aorta and may fill via collateral vessels.
RIGHT LEG: Occluded right external iliac stent. The right common femoral artery is reconstituted via collateral vessels
LEFT LEG: Occluded left external iliac stents reconstitution of the distal external iliac and common femoral via collateral vessels.
LUNG BASE: Atelectasis. 3 mm subpleural nodule in the left lung base posteriorly. 3 mm calcified nodule in the right middle lobe.
LIVER: Homogeneous enhancement.
BILIARY: No biliary ductal dilatation.
PANCREAS: Homogeneous enhancement.
SPLEEN: Normal caliber.
KIDNEYS: Occluded left main renal artery stent with atrophic left kidney. No evidence of obstructing urinary calculus, hydronephrosis or focal renal mass
ADRENALS: Normal.
RETROPERITONEUM: No enlarged retroperitoneal lymph nodes.
BOWEL/MESENTERY: Normal caliber small bowel loops. Uncomplicated colonic diverticulosis
PELVIC ORGANS: Within normal limits for patient's age.
BONES: Mild degenerative changes in the lower lumbar facets. Hypertrophic endplate spurring lower thoracic and lumbar spine.

RIGHT Femoral Artery:
Tortuosity: There is mild tortuosity.
Calcification: mild
Minimum luminal diameters:
Common iliac: Occluded stent
External iliac: Occluded stent
Common femoral: 4 mm

LEFT Femoral Artery:
Tortuosity: There is mild tortuosity.
Calcification: There is mild calcification.
Minimum luminal diameters:
Common iliac: Occluded stent
External iliac: Occluded stent
Common femoral: 3.7 mm

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CONCLUSION: Chronic left main renal artery stent occlusion with atrophy of the left kidney.

Chronic occlusion of the distal abdominal aorta just proximal to the aortic bifurcation with chronic occlusion of bilateral common iliac artery and external iliac artery stents. There is reconstitution of the common femoral arteries bilaterally via
collateral vessels.

3 mm noncalcified left lower lobe pulmonary nodule.

Normal caliber bowel loops with uncomplicated colonic diverticulosis.