34203 Embolectomy or thrombectomy, with or without catheter; popliteal-tibio-peroneal artery, by leg incision

Name of the Procedure:

Embolectomy or Thrombectomy, with or without catheter; Popliteal-Tibio-Peroneal Artery, by Leg Incision

Summary

An embolectomy or thrombectomy involves the surgical removal of blood clots (emboli or thrombi) from the arteries. This specific procedure targets the arteries below the knee – the popliteal, tibial, and peroneal arteries – using a leg incision. A catheter may or may not be used.

Purpose

The procedure addresses blood clots that obstruct blood flow in the arteries of the lower leg. The goal is to restore proper circulation and prevent tissue damage, which can help save the affected limb and improve overall health.

Indications

• Sudden pain or loss of function in the leg due to blocked arteries.
• Symptoms of critical limb ischemia, like severe rest pain or tissue loss.
• Diagnosed blood clots in the popliteal-tibio-peroneal arteries that cannot be resolved with medication alone.

Preparation

• Fasting for a specific period before the procedure, as advised by the doctor.
• Adjustment of certain medications, especially blood thinners.
• Pre-procedure imaging tests such as an angiogram, ultrasound, or MRI to locate the clot.

Procedure Description

1. The patient is given regional or general anesthesia to minimize pain and discomfort.
2. A leg incision is made to access the affected arteries.
3. The surgeon locates the clot and may use a catheter to help remove it.
4. Blood flow through the artery is restored by removing the clot.
5. The incision is then closed with sutures.

Duration

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

Setting

The procedure is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Vascular surgeon
• Anesthesiologist
• Surgical nurses
• Support staff as needed

Risks and Complications

• Infection at the incision site.
• Bleeding or bruising.
• Damage to the blood vessel or surrounding tissues.
• Recurrence of blood clots.
• Reaction to anesthesia.

Benefits

• Restoration of proper blood flow to the lower leg.
• Relief from pain and other symptoms associated with blocked arteries.
• Potentially saving the affected limb from severe damage or amputation.

Recovery

• Monitoring in a hospital for several hours to days, depending on patient condition.
• Instructions on wound care and activity levels post-surgery.
• Pain management with prescribed medications.
• Follow-up appointments to monitor progress and ensure proper healing.

Alternatives

• Medication-based thrombolysis to dissolve the clot (non-surgical option).
• Endovascular procedures utilizing balloon angioplasty or stenting.
• Pros and cons: Medications may be less invasive but not always effective for large clots; endovascular procedures are minimally invasive but may not be suitable for all clots.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-procedure, there may be discomfort at the incision site and a need for pain management. Expect to follow a recovery plan that includes rest, gradual return to activity, and consistent follow-up for optimal healing and monitoring.