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Anesthesia for procedures on arteries of knee and popliteal area; popliteal excision and graft or repair for occlusion or aneurysm

CPT4 code

Name of the Procedure:

Anesthesia for procedures on arteries of the knee and popliteal area; popliteal excision and graft or repair for occlusion or aneurysm.

Summary

This procedure involves administering anesthesia specifically for surgeries on the arteries located around the knee and popliteal area. The surgical intervention could include an excision (removal) and grafting or repairing arteries, often due to blockages (occlusions) or abnormal bulges (aneurysms).

Purpose

The purpose is to treat conditions where arteries in the knee or popliteal area are blocked or have developed aneurysms. The goal is to restore normal blood flow and prevent complications such as tissue damage, pain, or even potential limb loss.

Indications

  • Symptoms of artery blockage such as severe pain, numbness, or leg weakness.
  • Presence of an aneurysm detected through imaging studies.
  • Poor blood circulation in the legs.
  • Previous ineffective non-surgical treatment attempts.

Preparation

  • Patients are usually required to fast for 8 hours before the surgery.
  • Adjustments to current medications may be needed; blood thinners often need to be paused.
  • Preoperative evaluations such as blood tests, imaging studies (CT, MRI, or ultrasound), and possibly consultations with the anesthesiologist and cardiologist.

Procedure Description

  1. The surgical team administers anesthesia to ensure the patient is unconscious and pain-free.
  2. The surgeon makes an incision near the knee or popliteal area.
  3. The occluded or aneurysmal artery is exposed.
  4. The impaired section is either excised and replaced with a graft or repaired.
  5. The incision is closed, and the area is bandaged.
    • Tools: Surgical instruments, vascular graft materials, imaging devices.
    • Anesthesia: Typically, general anesthesia is used for patient comfort and immobility.

Duration

The procedure typically takes between 2 to 5 hours depending on the complexity of the case.

Setting

The procedure is usually performed in a hospital operating room.

Personnel

  • Vascular Surgeon
  • Anesthesiologist
  • Surgical Nurses
  • Surgical Technicians
  • Radiologist (if imaging assistance is needed)

Risks and Complications

  • Common risks: bleeding, infection, and reactions to anesthesia.
  • Rare risks: nerve damage, blood clots, or vessel rupture, leading to severe complications.
  • Management: Complications are managed with medications, surgical interventions, or close monitoring post-surgery.

Benefits

  • Restoration of proper blood flow.
  • Relief from pain and other symptoms associated with blocked arteries.
  • Prevention of further complications like limb loss.
  • Benefits are often realized soon after recovery from surgery.

Recovery

  • Initial recovery involves close monitoring in the hospital for 1-3 days.
  • Patients may need to avoid strenuous activities for several weeks.
  • Follow-up appointments are scheduled to monitor progress and healing.
  • Medication may be prescribed to manage pain and prevent blood clots.

Alternatives

  • Angioplasty with stenting: Minimally invasive but may not be suitable for all cases.
  • Medical therapy: Lifestyle changes and medications, less invasive but might not resolve severe cases.
  • Each alternative has its pros and cons, and suitability depends on individual patient conditions.

Patient Experience

  • Under anesthesia, the patient will be unconscious and will not feel pain during the surgery.
  • Post-procedure, some discomfort or pain at the surgical site is normal, managed with pain medication.
  • Physical sensations include mild to moderate pain, some swelling, and restricted mobility during the initial recovery phase.
  • Comfort measures: pain management with medication, proper wound care, and guidance from the medical team.

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