34845 Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modula

Name of the Procedure:

Endovascular Repair of Visceral Aorta and Infrarenal Abdominal Aorta with a Fenestrated Visceral Aortic Endograft and Concomitant Unibody or Modular Graft

Summary

In this advanced procedure, doctors use minimally invasive techniques to repair damaged sections of the visceral aorta and infrarenal abdominal aorta. A specialized stent graft is inserted through small incisions to stabilize and reinforce the blood vessel walls, addressing complications such as aneurysms or traumatic injuries.

Purpose

This procedure addresses problems in the visceral aorta and infrarenal abdominal aorta, like aneurysms, dissections, and other structural weaknesses. The main goal is to prevent rupture or further damage to these critical blood vessels, ensuring stable blood flow and reducing the risk of life-threatening complications.

Indications

• Aneurysms in the visceral or infrarenal abdominal aorta
• Pseudoaneurysms
• Aortic dissections
• Penetrating aortic ulcers
• Intramural hematomas
• Traumatic disruptions of the aorta

Patients who require this procedure often present with symptoms such as pain in the abdomen or back, swelling, or signs of compromised blood flow.

Preparation

• Patients may be instructed to fast for a specified period before the procedure.
• Medication adjustments, especially blood thinners, may be necessary.
• Pre-procedure imaging studies like CT scans or MRIs are typically required to map the vascular anatomy.
• Routine blood tests and cardiovascular assessments to ensure patient readiness.

Procedure Description

1. Anesthesia: The patient is given general or regional anesthesia to ensure comfort.
2. Access: Small incisions are made, usually in the groin, to access the femoral arteries.
3. Insertion: A catheter is guided through the arteries to the damaged area using real-time imaging.
4. Deployment: The fenestrated stent graft is carefully positioned and deployed to cover the aneurysm or damaged section.
5. Stabilization: The graft adheres to the aortic walls, reinforcing them and restoring proper blood flow.
6. Completion: The tools are withdrawn, and the incisions are closed.

Duration

The procedure typically takes 2-4 hours.

Setting

This procedure is performed in a hospital, specifically in an advanced operating room equipped with imaging technology.

Personnel

• Vascular surgeons
• Interventional radiologists
• Anesthesiologists
• Operating room nurses and technicians

Risks and Complications

• Bleeding or infection at the incision site
• Blood clots
• Graft migration or leakage
• Kidney complications from contrast dye
• Rare instances of stroke or heart attack

Benefits

• Reduced risk of aortic rupture
• Minimally invasive with smaller incisions
• Shorter recovery time compared to open surgery
• Improved blood flow and stabilization of the aorta

Recovery

• Hospital stay of 1-2 days for monitoring
• Pain management with medications
• Instructions on limited physical activities initially
• Follow-up imaging to ensure the graft is properly positioned and functioning
• Gradual return to daily activities over a few weeks

Alternatives

• Open surgical repair, which involves a larger incision and longer recovery time.
• Medical management with regular monitoring, although this is often less effective for severe cases.

Patient Experience

During the procedure, the patient remains under anesthesia and will not feel pain. Post-procedure, they may experience some discomfort at the incision sites and will be provided with pain management. Most patients can expect to return to normal activities within a few weeks, with significant improvement in symptoms related to the aortic condition.