34201 Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision

Name of the Procedure:

Embolectomy or Thrombectomy, with or without catheter; Femoropopliteal, Aortoiliac Artery, by Leg Incision

Summary

An embolectomy or thrombectomy is a surgical procedure to remove a blood clot (embolus or thrombus) from the femoropopliteal or aortoiliac artery. This helps to restore normal blood flow and prevent further complications.

Purpose

The procedure addresses blockages in the arteries of the leg due to blood clots. The primary goal is to restore blood flow to the affected area, thus relieving symptoms such as pain and reducing the risk of tissue damage or loss.

Indications

• Acute limb ischemia (sudden decrease in blood flow to the limb)
• Symptoms such as severe pain, paleness, or coolness in the leg
• Patients with a history of blood clots or vascular disease

Preparation

• Patients may be instructed to fast several hours before the procedure.
• Blood tests, imaging studies (e.g., ultrasound, angiography), and physical examinations are typically performed beforehand.
• Medication adjustments may be necessary, particularly blood thinners.

Procedure Description

1. The patient is positioned, and local or general anesthesia is administered.
2. An incision is made over the thigh (femoropopliteal) or abdomen/groin (aortoiliac).
3. A catheter or surgical tool is inserted into the artery.
4. The clot is located and carefully removed using the catheter or tool.
5. The artery is repaired, and the incision is closed with sutures.
6. The patient is then monitored in a recovery area.

Duration

The procedure typically takes 1 to 3 hours, depending on the complexity and location of the clot.

Setting

Performed in a hospital operating room.

Personnel

• Vascular surgeon
• Nurses
• Anesthesiologist
• Surgical technician

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma
• Damage to the artery or surrounding tissues
• Blood clot recurrence
• Anesthesia-related complications

Benefits

• Restores normal blood flow to the affected limb
• Reduces pain and associated symptoms
• Prevents tissue damage and potential loss of the limb
• Immediate improvement in symptoms can often be noticed

Recovery

• Patients may need to stay in the hospital for a few days for observation.
• Pain management and wound care instructions will be provided.
• Gradually reintroduce activities based on the surgeon’s advice.
• Follow-up appointments to monitor recovery and check for any complications.

Alternatives

• Anticoagulant or thrombolytic (clot-dissolving) medications
• Angioplasty and stenting
• Surgical bypass of the affected artery
• Each alternative has its own set of advantages and disadvantages, which should be discussed with the healthcare provider.

Patient Experience

• Patients may feel some discomfort and pain post-surgery, managed with pain medications.
• Swelling and bruising at the incision site are common.
• Most patients experience a significant improvement in symptoms once recovery is underway.