Name of the Procedure:

Anesthesia for procedures on arteries of knee and popliteal area; popliteal thromboendarterectomy, with or without patch graft

Summary

This procedure involves administering anesthesia for a surgery that removes a blood clot from the popliteal artery, located behind the knee. During the surgery, the artery may also be repaired with a patch graft. The anesthesia ensures that the patient feels no pain during the procedure.

Purpose

The procedure aims to restore proper blood flow in the popliteal artery, which may be blocked by a thrombus (blood clot). This blockage can cause pain, numbness, or serious complications in the leg, such as tissue damage or loss. The expected outcome is improved blood circulation and relief from symptoms caused by the arterial blockage.

Indications

• Symptoms such as pain, numbness, or coldness in the lower leg or foot.
• Diagnosis of a blood clot in the popliteal artery.
• Poor blood circulation below the knee due to arterial blockage.
• Risk of tissue damage or loss in the affected leg.

Preparation

• Fasting for a specified period before the procedure, usually 6-8 hours.
• Adjustments to current medications as advised by the healthcare provider.
• Preoperative diagnostic tests such as blood work, ECG, or imaging studies to assess the condition of the artery.
• Consultation with the anesthesiologist for anesthesia planning.

Procedure Description

1. The patient is brought into the operating room and positioned appropriately.
2. An IV line is inserted for medication administration.
3. Anesthesia is administered: options include general anesthesia, where the patient is fully unconscious, or regional anesthesia, such as a spinal or epidural block, which numbs the lower body.
4. The surgeon makes an incision behind the knee to access the popliteal artery.
5. The thrombus (blood clot) is carefully removed from the artery.
6. If required, a patch graft is applied to repair the artery.
7. The incision is closed, and the patient is moved to recovery.

Tools and equipment used may include scalpels, vascular clamps, patch graft material, and standard surgical instruments.

Duration

The procedure generally takes about 2 to 4 hours, depending on the complexity and whether a patch graft is needed.

Setting

The procedure is typically performed in a hospital surgical suite or a specialized vascular surgery center.

Personnel

• Vascular Surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologists

Risks and Complications

• Common risks: infection, bleeding, reactions to anesthesia
• Rare risks: nerve damage, artery damage requiring additional repair, blood clots, longer-term numbness or weakness in the leg

Benefits

• Restored blood flow to the lower leg.
• Relief from pain, numbness, or coldness in the affected leg.
• Reduced risk of tissue damage or loss.
• Improved overall limb function.

Recovery

• Monitoring in a recovery room until anesthetics wear off.
• Pain management with prescribed medications.
• Instructions for wound care, activity restrictions, and signs of complications to watch for.
• Follow-up appointments with the vascular surgeon to assess healing and blood flow.

Expected recovery time varies, usually a few weeks for initial recovery, with full recovery taking up to several months.

Alternatives

• Medication management with blood thinners to dissolve the clot.
• Less invasive treatments like catheter-directed thrombolysis.
• Bypass surgery if the blockage can't be removed or if thromboendarterectomy isn’t an option.

Each alternative has different risks and benefits that should be discussed with the healthcare provider.

Patient Experience

During the procedure, under anesthesia, the patient will feel no pain. After the procedure, pain and discomfort at the incision site are common, but these can be managed with medication. Swelling and bruising may also occur. The patient will need to follow specific post-operative care instructions to ensure proper healing and return to normal activities as advised by the healthcare provider.