35741 Exploration (not followed by surgical repair), with or without lysis of artery; popliteal artery

Name of the Procedure:

Exploration of Popliteal Artery (with or without lysis of artery)

Summary

Exploration of the popliteal artery involves examining this major blood vessel located behind the knee to identify any blockages, injuries, or abnormalities. This procedure may or may not include lysis (removal) of any clots or fibrous tissue causing a blockage.

Purpose

The procedure addresses issues such as blockages, trauma, or unexplained pain in the popliteal artery region. The goal is to evaluate the artery thoroughly and, if needed, to restore blood flow in cases where clots or blockages are found.

Indications

• Symptoms include pain, swelling, or changes in skin color in the lower leg.
• Conditions like peripheral artery disease, trauma, or embolism.
• Patients experiencing intermittent claudication or acute limb ischemia.

Preparation

• Patients may need to fast for 6-8 hours before the procedure.
• Blood tests and imaging studies like Doppler ultrasound or angiography are typically done prior.
• Adjustments in medication, particularly blood thinners, may be necessary.

Procedure Description

1. The patient is positioned and prepped in a sterile manner.
2. General or regional anesthesia is administered.
3. An incision is made near the knee to access the popliteal artery.
4. The artery is carefully examined for any abnormalities, blockages, or injuries.
5. If present, clots or fibrous tissue may be lysed or removed.
6. The incision is then closed, and the site is dressed.

Duration

The procedure generally takes 1-2 hours.

Setting

It is typically performed in a hospital or surgical center.

Personnel

• Vascular surgeon
• Anesthesiologist
• Operating room nurses
• Surgical technician

Risks and Complications

• Bleeding
• Infection
• Nerve damage
• Blood clots
• Reaction to anesthesia
• Vascular complications such as pseudoaneurysm or arterial occlusion

Benefits

• Accurate diagnosis of arterial issues.
• Potential improvement in symptoms such as pain and swelling.
• Restoration of proper blood flow if blockages were addressed.

Recovery

• Hospital stay of 1-2 days may be required for monitoring.
• Instructions include wound care and activity restrictions.
• Follow-up appointments for wound check and further imaging may be necessary.
• Recovery time varies; most resume normal activities within a few weeks.

Alternatives

• Non-invasive imaging techniques for diagnostic purposes.
• Endovascular procedures like angioplasty or stenting.
• Conservative management with medication and lifestyle changes.
• Each alternative has its pros and cons concerning invasiveness, recovery time, and effectiveness.

Patient Experience

• During the procedure, patients under general anesthesia won't feel anything.
• For regional anesthesia, they may be awake but won't feel pain.
• Post-procedure discomfort at the incision site can be managed with pain medication.
• Some bruising and swelling are normal and should subside within a few days.