34841 Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and inte

Name of the Procedure:

Endovascular Repair of Visceral Aorta (e.g., aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by Deployment of a Fenestrated Visceral Aortic Endograft

Summary

In layman's terms, this procedure involves fixing problems in the main artery that supplies blood to your organs by inserting a special tube (endograft) through a small incision. This minimizes the need for a large surgical operation.

Purpose

This procedure addresses issues like aneurysms (weak, bulging spots), pseudoaneurysms (false aneurysms), dissections (splits), penetrating ulcers, intramural hematomas (bleeding within the artery walls), and traumatic disruptions in the visceral (organ-supplying) part of the aorta. The goal is to stabilize the aorta, prevent rupture, and restore normal blood flow.

Indications

Patients may need this procedure if they experience:

• Severe abdominal or back pain.
• Detection of an aneurysm or dissection through imaging.
• Symptoms related to compromised blood flow to abdominal organs.

Appropriate candidates are those who are high-risk for open surgery, have suitable anatomy for endograft deployment, and have undergone thorough diagnostic imaging.

Preparation

• Patients may need to fast for 8-12 hours before the procedure.
• Medication adjustments might be necessary, especially blood thinners.
• Pre-procedure diagnostics often include CT or MRI scans to accurately map the aorta.

Procedure Description

1. Under anesthesia, a small incision is made in the groin area.
2. A catheter is inserted into the blood vessel and guided to the affected area of the aorta under X-ray supervision.
3. The fenestrated endograft (a tube with openings for side branches) is deployed to cover the damaged area.
4. Once in place, the endograft expands and anchors inside the aorta to divert blood flow away from the problem site.
5. The catheter is removed, and the incision is closed.

Tools: Catheter, fenestrated endograft, X-ray imaging equipment.

Anesthesia: General anesthesia or local anesthesia with sedation.

Duration

The procedure typically takes 2-4 hours.

Setting

The procedure is performed in a hospital's specialized operating room or a cardiovascular intervention suite.

Personnel

• Vascular Surgeon or Interventional Radiologist
• Anesthesiologist
• Surgical Nurses
• Radiology Technicians

Risks and Complications

Common: Bleeding, infection, minor vessel injury. Rare: Graft migration or blockage, organ injury, need for additional interventions.

Benefits

• Minimally invasive, shorter recovery time.
• Reduced risk of complications compared to open surgery.

• Immediate stabilization of the aorta.

  Recovery

• Hospital stay of 1-2 days for monitoring.
• Avoid heavy lifting and strenuous activities for a few weeks.
• Follow-up appointments for imaging to ensure the graft is functioning well.

Alternatives

• Open surgical repair: More invasive with longer recovery but effective for those not suitable for endograft.
• Medical management: Suitable for small, asymptomatic aneurysms but includes regular monitoring.

Patient Experience

During the procedure, patients under general anesthesia will be asleep and feel no pain. Post-procedure, mild discomfort or soreness at the incision site is common, and pain can be managed with medication. Full recovery usually takes a few weeks, during which activities might be limited.