35703 Exploration not followed by surgical repair, artery; lower extremity (eg, common femoral, deep femoral, superficial femoral, popliteal, tibial, peroneal)

Name of the Procedure:

Exploration not followed by surgical repair, artery; lower extremity (e.g., common femoral, deep femoral, superficial femoral, popliteal, tibial, peroneal).

Summary

An "Exploration not followed by surgical repair" in the context of lower extremity arteries involves examining the arteries in the legs to diagnose issues, without performing immediate surgical repairs.

Purpose

This procedure is performed to identify abnormalities or confirm diagnoses related to the arteries in the lower extremities. The goals are to determine the exact issue affecting the arteries, which may include blockages, tears, or other vascular conditions.

Indications

• Persistent leg pain or claudication (pain induced by walking)
• Signs of arterial obstruction or thrombosis
• Unusual swelling in the legs
• Non-healing wounds or ulcers on the legs
• Severe trauma to the lower extremities suggesting vascular injury

Preparation

• Patients may need to fast for several hours prior to the procedure.
• Medication adjustments may be necessary, particularly if the patient is on blood thinners.
• Pre-procedure assessments will likely include imaging studies like Doppler ultrasound, CT angiography, or MRI.

Procedure Description

1. The patient is positioned to allow clear access to the affected leg.
2. Local or general anesthesia is administered.
3. The surgeon makes an incision to expose the artery in question.
4. The artery is carefully examined using specialized instruments and techniques.
5. No repairs are made during this exploration; the focus is purely diagnostic.
6. The incision is closed and bandaged.

Duration

Typically, the procedure takes about 1 to 2 hours, depending on the complexity of the examination.

Setting

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

Personnel

• Vascular surgeon
• Surgical nurses
• Anesthesiologist

Risks and Complications

• Bleeding or hematoma formation at the incision site
• Infection
• Blood vessel damage
• Allergic reactions to anesthesia or contrast materials
• Rarely, nerve damage

Benefits

• Accurate diagnosis of vascular conditions
• Informing treatment decisions for potential future interventions

Recovery

• Patients may need to stay in the hospital for observation, usually for a few hours to a day.
• Follow-up instructions include keeping the incision site clean and dry.
• Patients may need to avoid strenuous activities for a few days.
• Follow-up appointments will be scheduled to discuss findings and next steps.

Alternatives

• Non-invasive imaging like MRI angiography or CT angiography
• Invasive procedures such as angiography for both diagnostic and therapeutic purposes

Each alternative has its pros and cons: non-invasive imaging avoids surgery but might not be as detailed; angiography can double as a treatment but carries its own risk profile.

Patient Experience

During the procedure, the patient will be under local or general anesthesia, so they should not feel pain. Some discomfort or pain might be experienced at the incision site post-procedure, managed with pain medication and rest. Patients can expect to resume normal activities within a few days, following their doctor's advice.

Pain management and comfort measures include prescribed pain relievers, adequate rest, and proper wound care to ensure smooth recovery.