34812 Open femoral artery exposure for delivery of endovascular prosthesis, by groin incision, unilateral (List separately in addition to code for primary procedure)

Open Femoral Artery Exposure for Delivery of Endovascular Prosthesis, by Groin Incision, Unilateral

Name of the Procedure:

• Common Names: Open Femoral Artery Exposure, Endovascular Prosthesis Insertion
• Medical Terms: Femoral Artery Exposure, Endovascular Stent Graft Placement

Summary

This procedure involves making an incision in the groin area to expose the femoral artery, allowing for the insertion of an endovascular prosthesis (such as a stent graft) to treat vascular issues. This is done on one side of the groin.

Purpose

• Medical Condition: Often used to address blockages or aneurysms in the arteries.
• Goals: To restore proper blood flow and prevent complications such as aneurysm rupture or limb ischemia.
• Expected Outcomes: Improved vascular function and reduced risk of vascular complications.

Indications

• Symptoms: Severe leg pain, claudication, non-healing leg ulcers.
• Conditions: Peripheral artery disease (PAD), aneurysms of the femoral artery.
• Patient Criteria: Typically indicated for patients with significant arterial blockages not amenable to less invasive procedures.

Preparation

• Pre-procedure Instructions: May include fasting for 6-8 hours prior and ceasing certain medications.
• Diagnostic Tests: Blood tests, imaging studies (e.g., ultrasound, CT angiography) to evaluate the extent of arterial disease.

Procedure Description

1. Anesthetic Administration: Regional (spinal/epidural) or general anesthesia.
2. Initial Incision: A small incision is made in the groin area to access the femoral artery.
3. Exposure of the Artery: The femoral artery is carefully exposed and prepared for the insertion of the prosthesis.
4. Insertion of Prosthesis: An endovascular prosthesis (stent graft) is delivered into the artery using specialized catheters and guided by imaging.
5. Securing the Prosthesis: The stent graft is positioned and deployed to ensure proper placement.
6. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes about 1-2 hours.

Setting

Performed in a hospital operating room or specialized vascular surgical center.

Personnel

• Surgeons: Vascular surgeon or interventional radiologist.
• Anesthesiologists: Administering and monitoring anesthesia.
• Nurses: Assisting during the procedure and in post-operative care.
• Technicians: Operating imaging equipment.

Risks and Complications

• Common Risks: Infection, bleeding, blood clots.
• Rare Risks: Nerve damage, allergic reaction to anesthesia, graft failure.
• Management: Close monitoring and immediate intervention as needed.

Benefits

• Expected Benefits: Improved blood flow, relief from symptoms, and reduced risk of severe complications.
• Realization: Many patients experience symptom relief shortly after the procedure.

Recovery

• Post-procedure Care: Monitoring in recovery room, pain management, instructions for home care.
• Recovery Time: Generally, a few weeks to return to normal activities; follow-up appointments to assess progress.

Alternatives

• Other Options: Medication management, lifestyle changes, less invasive catheter-based procedures.
• Pros and Cons: Non-surgical options may be less risky but less effective for severe arterial disease.

Patient Experience

• During the Procedure: Patients will be under anesthesia and should not feel pain.
• After the Procedure: Some discomfort and pain managed with medications; detailed instructions for activity restrictions and wound care will be provided to support recovery and prevent complications.