Embolectomy or thrombectomy, with or without catheter; renal, celiac, mesentery, aortoiliac artery, by abdominal incision
CPT4 code
Name of the Procedure:
Embolectomy or Thrombectomy, with or without Catheter; Renal, Celiac, Mesentery, Aortoiliac Artery, by Abdominal Incision
Summary
An embolectomy or thrombectomy is a surgical procedure used to remove a blood clot (embolus or thrombus) from blood vessels in specific abdominal arteries. These arteries include the renal, celiac, mesentery, and aortoiliac arteries. The procedure can be performed using a catheter or through an incision in the abdomen.
Purpose
This procedure is performed to restore normal blood flow to the affected organs and tissues by removing the obstructing clot. The primary goal is to prevent tissue damage and organ failure caused by the restricted blood flow.
Indications
- Acute onset of symptoms such as severe abdominal pain, vomiting, or diarrhea.
- Evidence of compromised blood flow to the kidneys, liver, intestines, or lower extremities.
- Patients experiencing critical limb ischemia or symptoms of severe arterial blockage.
- Diagnostic imaging that confirms the presence of a blood clot in the pertinent arteries.
Preparation
- Patients may need to fast for several hours before the procedure.
- Patients must disclose current medications, and they may need to stop taking blood thinners.
- Preoperative imaging studies, such as CT angiography or Doppler ultrasound, are required to locate the clot.
- Routine blood tests to check kidney function and clotting parameters.
Procedure Description
- Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
- Incision: An incision is made in the abdomen to access the affected artery.
- Clot Removal: A catheter may be inserted, or a direct approach may be used to remove the clot from the artery.
- Restoration: After the clot is removed, blood flow to the artery and surrounding tissues is restored.
- Closure: The incision is closed with sutures, and the area is bandaged.
Duration
The procedure typically takes between 2 to 4 hours, depending on the complexity and location of the clot.
Setting
This procedure is performed in a hospital surgical suite or an advanced outpatient surgical center.
Personnel
- Vascular Surgeon
- Surgical Nurses
- Anesthesiologist
- Radiologic Technologists (if imaging is required during the procedure)
Risks and Complications
- Infection at the incision site.
- Bleeding or hematoma formation.
- Blood vessel damage.
- Reoccurrence of the clot.
- Reaction to anesthesia.
- Kidney failure or other organ dysfunction.
Benefits
- Restoration of normal blood flow.
- Prevention of tissue damage and organ failure.
- Relief from acute symptoms caused by the blocked artery.
Recovery
- Patients are monitored in a recovery room immediately after surgery.
- Hospital stay typically lasts 1-3 days.
- Pain management strategies include prescribed pain medication.
- Restrictions may include avoiding heavy lifting and strenuous activities for several weeks.
- Follow-up appointments to monitor recovery and ensure the success of the procedure.
Alternatives
- Anticoagulation therapy to dissolve clot non-surgically.
- Percutaneous transluminal angioplasty with stenting.
- Bypass surgery in severe cases.
Pros and Cons of Alternatives
- Anticoagulation therapy: Non-invasive but may not be effective for large or resistant clots.
- Angioplasty with stenting: Minimally invasive but may not be suitable for all clot locations.
- Bypass surgery: Effective for severe blockages but is more invasive and requires a longer recovery.
Patient Experience
- During the procedure: Patients will be under general anesthesia and not conscious.
- After the procedure: Patients may feel pain and discomfort at the incision site. Pain management will be provided.
- Patients can expect a gradual return to normal activities, with full recovery taking several weeks to months.
Pain management and careful monitoring during recovery are essential to ensure comfort and prompt detection of any complications.