Name of the Procedure:

Anesthesia for Procedures Involving Arteries of Upper Leg, Including Bypass Graft; Femoral Artery Ligation

Summary

This procedure involves administering anesthesia to allow surgeons to perform operations on the major arteries of the upper leg. These operations may include bypass grafts, which help restore blood flow, or femoral artery ligation, which involves tying off a damaged artery.

Purpose

The procedure aims to treat conditions such as peripheral artery disease, critical limb ischemia, or aneurysms in the upper leg arteries. The expected outcome is improved blood flow and reduced symptoms like pain and impaired mobility.

Indications

• Severe peripheral artery disease
• Critical limb ischemia
• Aneurysms in the femoral artery
• Chronic pain and mobility issues due to blocked or damaged arteries

Preparation

• Patients may be required to fast for 8 hours before the procedure.
• Medication adjustments might be needed, especially for blood thinners.
• Pre-procedure imaging tests such as an ultrasound or angiogram to assess the arteries.

Procedure Description

1. Pre-operative assessments and confirmation of patient identity and procedure.
2. Administration of anesthesia. This often involves general anesthesia but can include regional anesthesia depending on the extent of the surgery.
3. Monitoring of vital signs throughout the procedure using specialized equipment.
4. The surgical team will then proceed with the specific arterial surgery, such as a bypass graft or femoral artery ligation.
5. After the surgery, the anesthesia is gradually withdrawn, and the patient is monitored during the recovery phase.

Duration

The procedure typically takes 3 to 4 hours, but this can vary depending on the complexity of the surgery.

Setting

The procedure is performed in a hospital's operating room to ensure access to necessary surgical and anesthetic equipment.

Personnel

• Anesthesiologist
• Surgical team, including vascular surgeons
• Nurses and surgical technologists
• Monitoring technicians

Risks and Complications

• General anesthesia risks: allergic reactions, breathing difficulties
• Surgical risks: bleeding, infection, blood clots
• Arterial damage or ineffective blood flow restoration
• Nerve damage in the adjacent area

Benefits

• Improved blood flow to the affected leg
• Reduction or elimination of pain
• Enhanced mobility and quality of life
• Prevention of more severe complications like limb loss

Recovery

• Initial recovery in a post-anesthesia care unit (PACU)
• Monitoring for any immediate post-op complications (e.g., bleeding, infection)
• Pain management with prescribed medications
• Gradual return to normal activities over 6-8 weeks depending on individual recovery
• Follow-up appointments for progress assessment

Alternatives

• Angioplasty with or without stenting
• Medical management with medications and lifestyle changes
• Endovascular procedures (less invasive than traditional surgery)
• Each alternative varies in effectiveness, risks, recovery time, and suitability based on individual patient conditions.

Patient Experience

• Expectation of being fully unconscious (general anesthesia) or numb from the waist down (regional anesthesia) during the procedure.
• Post-procedure, patients may experience discomfort or soreness at the surgical site.
• Pain management through prescribed medication.
• Gradual resumption of daily activities as advised by the healthcare team.