34111 Embolectomy or thrombectomy, with or without catheter; radial or ulnar artery, by arm incision

Name of the Procedure:

Embolectomy or Thrombectomy, with or without Catheter; Radial or Ulnar Artery, by Arm Incision

Summary

An embolectomy or thrombectomy is a surgical procedure to remove a blood clot (embolus or thrombus) from the radial or ulnar artery in the arm. The procedure can be performed with or without the use of a catheter inserted through an incision in the arm.

Purpose

The procedure is performed to restore proper blood flow in cases where a blood clot is obstructing an artery in the arm, which can cause pain, tissue damage, or other serious complications.

Indications

• Sudden onset of arm pain and swelling
• Signs of poor circulation in the arm, such as blue or pale skin, coldness, or numbness
• Confirmed blood clot in the radial or ulnar artery, detected via imaging tests

Preparation

• Patients may be advised to fast for several hours before the procedure.
• Certain medications, especially blood thinners, might need to be paused as per doctor’s advice.
• Pre-procedural imaging tests like Doppler ultrasound or angiography may be performed.

Procedure Description

1. The patient is given anesthesia – typically local or regional, with possible sedation, depending on the case.
2. An incision is made in the arm to access the radial or ulnar artery.
3. A catheter may be inserted to guide the removal of the blood clot.
4. The clot is carefully extracted, either manually or with specialized instruments.
5. The artery is inspected to ensure full restoration of blood flow.
6. The incision is closed with sutures or surgical staples, and a bandage is applied.

Duration

The procedure typically takes between 1 to 2 hours.

Setting

This procedure is generally performed in a hospital operating room or specialized surgical center.

Personnel

• A vascular surgeon
• Surgical nurses
• An anesthesiologist or nurse anesthetist

Risks and Complications

• Bleeding
• Infection at the incision site
• Nerve damage
• Recurrent blood clots
• Vascular injury
• Complications from anesthesia

Benefits

• Restoration of normal blood flow to the arm
• Relief from pain and symptoms caused by the blood clot
• Prevention of more severe complications, such as tissue damage or loss of limb

Recovery

• Patients are usually monitored in a recovery area immediately post-procedure.
• Instructions will include care for the incision site, activity limitations, and possibly taking blood thinners.
• Most patients can resume normal activities within a few weeks, but strenuous activities should be avoided for a specified period.
• Follow-up appointments are necessary to check for proper healing and ensure that the artery remains clear.

Alternatives

• Thrombolytic therapy (using medication to dissolve the clot)
• Endovascular procedures (minimally invasive techniques)
• Conservative treatments with anticoagulants (blood thinners)
• Each alternative has different risks and effectiveness, which should be discussed with the healthcare provider.

Patient Experience

• Mild discomfort or pain at the incision site, which can be managed with prescribed pain medications.
• Some swelling and bruising may occur around the incision.
• Temporary activity restrictions to promote healing, with gradual return to normal activities.

Patients should feel well-informed and support through the process, ensuring an optimal experience and outcome.