Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with autogenous vein patch graft
CPT4 code
Name of the Procedure:
Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with autogenous vein patch graft.
Summary
This surgery involves correcting or repairing a synthetic arterial bypass graft in the groin area by using a patch made from the patient’s own vein. The procedure is done through an open surgical approach.
Purpose
The procedure addresses issues such as blockage or malfunction of a synthetic arterial bypass graft located in the groin. The goal is to restore proper blood flow and function, relieving symptoms like poor circulation and pain.
Indications
- Symptoms of graft failure such as leg pain, swelling, or ulcers.
- Diagnostic tests showing graft occlusion or narrowing.
- Patients with symptoms of peripheral arterial disease not responsive to non-surgical treatments.
Preparation
- Patients may need to fast for a specific period before the surgery.
- Adjustments to medications, particularly blood thinners, will be advised.
- Pre-operative diagnostic tests such as ultrasound, CT scan, or angiography to assess the affected area.
Procedure Description
- The patient is placed under general anesthesia.
- An incision is made in the groin area to expose the synthetic arterial bypass graft.
- The problematic section of the graft is identified.
- A segment of the patient’s own vein, often taken from the leg, is prepared for use as a patch.
- The vein patch is sewn onto the graft to repair the affected area.
- The incision is closed, and a dressing is applied.
Tools used include surgical instruments for making the incision, suturing equipment, and monitoring devices. General anesthesia is administered to ensure the patient is comfortable and pain-free during the procedure.
Duration
The procedure typically takes around 2 to 3 hours, depending on the complexity.
Setting
The surgery is performed in a hospital operating room.
Personnel
- Vascular Surgeon
- Anesthesiologist
- Surgical Nurses
- Scrub Technicians
Risks and Complications
- Common risks: Infection, bleeding, graft occlusion.
- Rare risks: Allergic reactions to anesthesia, blood clots, nerve damage.
- Complications are managed with medication, additional surgery, or other medical interventions.
Benefits
- Improved blood flow and circulation in the affected limb.
- Relief from symptoms like pain and swelling.
- Enhanced mobility and quality of life.
Benefits can often be realized within weeks to a few months post-surgery.
Recovery
- Post-operative care includes monitoring in a hospital setting for a few days.
- Instructions may involve wound care, activity restrictions, and taking prescribed medications.
- Recovery time can range from several weeks to a few months.
- Follow-up appointments for monitoring and additional imaging tests may be needed.
Alternatives
- Non-surgical options such as medication or lifestyle modifications.
- Endovascular procedures like angioplasty or stenting.
- Pros of alternatives include less invasiveness, while cons may include lower effectiveness or not being suitable for all patients.
Patient Experience
- During the procedure: The patient is under general anesthesia and will not feel anything.
- After the procedure: Expect some pain and discomfort at the incision site, managed with pain medications.
- Patients may also experience swelling and bruising which will decrease over time.
- Comfort measures include adequate pain management and support for mobility during recovery.