Thromboendarterectomy, including patch graft, if performed; deep (profunda) femoral
CPT4 code
Name of the Procedure:
Thromboendarterectomy of the Deep Femoral Artery Common Name(s): Profunda Femoral Thromboendarterectomy, Deep Femoral Artery Surgery
Summary
Thromboendarterectomy of the deep femoral artery is a surgical procedure to remove blood clots and plaque from the deep femoral artery (profunda femoris). If necessary, a patch graft is applied to repair the artery.
Purpose
Addresses: Blockage or narrowing of the deep femoral artery. Goals: Restore proper blood flow, alleviate symptoms like pain and cramping, and prevent tissue damage in the leg.
Indications
- Symptoms: Severe leg pain, cramping, or difficulty walking due to poor blood circulation.
- Conditions: Peripheral artery disease (PAD), deep femoral artery occlusion.
- Patient Criteria: Patients who have not responded to medication or lifestyle changes, or those with severe arterial blockages.
Preparation
Instructions:
- Fasting typically required for 8-12 hours before the procedure.
- Discontinuation or adjustment of certain medications as advised by your doctor. Diagnostic Tests:
- Blood tests, imaging studies (e.g., duplex ultrasound, CT angiography) to assess the blockage.
Procedure Description
Steps:
- Administer anesthesia—general or regional, depending on the patient's condition.
- Make an incision in the thigh to access the deep femoral artery.
- Remove the clot and plaque from the artery.
- If required, apply a patch graft to strengthen the artery wall.
- Close the incision with sutures or staples. Tools/Equipment: Surgical instruments, patch graft material. Anesthesia: General or regional anesthesia.
Duration
Typically, 2-3 hours.
Setting
Performed in a hospital operating room.
Personnel
Surgeons: Vascular surgeon. Others: Anesthesiologists, surgical nurses, scrub techs.
Risks and Complications
Risks:
- Infection at the surgical site
- Bleeding or hematoma
- Blood clots
- Artery damage or re-narrowing of the artery
- Anesthesia-related complications Complications: Managed with medication or additional surgical intervention if necessary.
Benefits
Expected Benefits:
- Improved blood flow and reduced symptoms.
- Increased ability to walk longer distances without pain. Realization Time: Benefits often realized within days to weeks after the procedure.
Recovery
Post-Procedure Care:
- Hospital stay of 1-3 days for monitoring.
- Pain management with prescribed medications.
- Avoid strenuous activities for several weeks.
- Follow-up appointments for wound checks and activity guidance. Recovery Time:
- Full recovery typically takes several weeks to a few months.
Alternatives
Other Treatment Options:
- Angioplasty with or without stent placement.
- Medication management and lifestyle modifications. Comparison:
- Angioplasty is less invasive but may not be as effective for severe blockages.
- Medications and lifestyle changes work better for less severe cases.
Patient Experience
During Procedure: Patients will be under anesthesia and should not feel pain during the procedure. After Procedure:
- Some discomfort and swelling at the incision site.
- Pain managed with medications.
- Gradual improvement in symptoms and mobility.