Name of the Procedure:

Anesthesia for procedures on arteries of lower leg, including bypass graft; embolectomy, direct or with catheter

Summary

This procedure involves administering anesthesia to numb the lower leg area undergoing surgery on its arteries. It commonly includes bypass grafting and embolectomy, where a blood clot is either surgically removed or extracted using a catheter.

Purpose

This procedure addresses arterial blockages or narrowings in the lower leg that can impede blood flow. The main goal is to restore proper circulation and prevent tissue damage or loss of limb due to poor blood supply.

Indications

• Severe pain in the lower leg due to blocked arteries
• Non-healing ulcers or gangrene on the foot or leg
• Intermittent claudication (pain while walking)
• Acute limb ischemia (sudden decrease of blood flow to the leg)

Preparation

• Fasting for at least 6-8 hours prior to the procedure
• Adjustments to current medications as instructed by the physician
• Diagnostic imaging like Doppler ultrasound, CT angiography, or MR angiography to assess the arteries

Procedure Description

1. The patient is prepped and positioned appropriately.
2. Anesthesia is administered, which may include local, regional, or general anesthesia depending on the surgery’s extent.
3. For bypass graft surgery, a vessel graft is used to create a new route around the blockage.
4. For embolectomy, a catheter or surgical incision is used to remove the clot directly.
5. Constant monitoring of the patient’s vitals throughout the procedure.

Duration

Typically, the procedure takes 1 to 3 hours, depending on its complexity.

Setting

Performed in a hospital operating room or a specialized surgical center.

Personnel

• Vascular surgeon
• Anesthesiologist
• Surgical nurses
• Possibly a radiologist, if imaging guidance is needed

Risks and Complications

• Infection
• Bleeding
• Damage to the artery or nearby tissues
• Reaction to anesthesia
• Blood clots
• Complications like stroke or heart attack

Benefits

• Restored blood flow to the lower leg
• Relief from symptoms like pain and cramping
• Prevention of severe complications such as tissue death or limb amputation
• Improved mobility and quality of life

Recovery

• Monitoring in a recovery room immediately post-procedure
• Pain management with prescribed medications
• Instructions on wound care and activity restrictions
• Follow-up appointments for assessment and possible imaging tests
• Full recovery may take several weeks to months, depending on individual healing processes.

Alternatives

• Medication to manage symptoms
• Minimally invasive procedures like angioplasty and stenting
• Lifestyle changes like exercise and diet modification
• The pros of these alternatives include less invasive intervention and quicker recovery, while cons may include lower effectiveness in severe cases.

Patient Experience

Patients may feel anxious before surgery but will be made comfortable with appropriate sedation and anesthesia. Post-procedure discomfort can usually be managed with pain medications, and support from the healthcare team will be provided to ensure a smooth recovery.