34820 Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy, by abdominal or retroperitoneal incision, unilateral (List separately in addition to code for primary procedure)

Name of the Procedure:

Open Iliac Artery Exposure for Delivery of Endovascular Prosthesis or Iliac Occlusion During Endovascular Therapy, by Abdominal or Retroperitoneal Incision, Unilateral

Summary

This surgical procedure involves exposing the iliac artery through an abdominal or retroperitoneal incision on one side of the body. It is commonly performed to deliver an endovascular prosthesis (a type of vascular graft) or to occlude (block) the iliac artery as part of endovascular therapy, often to treat vascular diseases.

Purpose

The procedure addresses conditions like aneurysms or blockages in the iliac artery. The goals are to improve blood flow, reduce the risk of artery rupture, and alleviate symptoms associated with poor circulation.

Indications

• Aneurysms in the iliac artery
• Blockages of the iliac artery
• Severe peripheral arterial disease
• Preparation for certain types of surgeries or endovascular therapies

Preparation

• Fasting for at least 8 hours before the procedure
• Adjustment of certain medications as advised by your doctor
• Pre-operative imaging tests such as CT scans or MRIs to map the area of concern

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made either in the abdomen or the retroperitoneal space.
3. The surgeon carefully exposes the iliac artery.
4. Depending on the specific need, either an endovascular prosthesis is delivered into the artery or it is occluded.
5. Instruments such as scalpels, retractors, and clamps are used.
6. The incision is closed with sutures or staples.

Duration

The procedure typically takes about 2-4 hours, depending on the complexity.

Setting

The procedure is performed in a hospital operating room.

Personnel

• Vascular Surgeon
• Anesthesiologist
• Surgical Nurses
• Surgical Technologists

Risks and Complications

• Infection
• Bleeding
• Damage to surrounding organs or structures
• Blood clots
• Adverse reactions to anesthesia
• Rarely, death

Benefits

• Improved blood flow
• Reduced risk of aneurysm rupture
• Relief from symptoms like pain and fatigue due to improved circulation
• Benefits typically realized within weeks post-procedure

Recovery

• Hospital stay of 3-7 days
• Instructions to avoid heavy lifting and strenuous activities for several weeks
• Follow-up appointments for wound care and monitoring
• Potential need for physical therapy

Alternatives

• Non-surgical management with medications and lifestyle changes
• Less invasive endovascular procedures without open incision
• Each alternative has pros and cons regarding recovery time, risks, and effectiveness.

Patient Experience

• The patient will be under general anesthesia during the procedure.
• Post-operatively, pain management will be provided through medications.
• Expect discomfort and mobility restrictions during the initial recovery period.
• Gradual return to normal activities under medical guidance.