Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, axillary-brachial artery, by arm incision
CPT4 code
Name of the Procedure:
Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, axillary-brachial artery, by arm incision.
Summary
This surgical procedure involves repairing or removing an aneurysm or pseudoaneurysm in the axillary-brachial artery, which is located in the arm. It may include the insertion of a graft to restore proper blood flow.
Purpose
The procedure addresses aneurysms or pseudoaneurysms of the axillary-brachial artery and related occlusive disease. The goal is to eliminate the aneurysm, ensure proper blood flow, and prevent complications such as rupture or blood clots.
Indications
- Presence of a diagnosed aneurysm or pseudoaneurysm in the axillary-brachial artery.
- Symptoms such as swelling, pain, or impaired circulation in the arm.
- Associated occlusive arterial disease causing decreased blood flow.
Preparation
- Patients may need to fast for a certain period before the procedure.
- Medication adjustments may be necessary; some blood thinners may need to be stopped.
- Pre-procedure imaging tests like an ultrasound, CT scan, or MRI may be required.
Procedure Description
- The patient is given anesthesia for comfort, usually general anesthesia.
- An incision is made in the arm to access the axillary-brachial artery.
- The aneurysm or pseudoaneurysm is identified.
- Depending on the aneurysm's condition, it may be repaired directly, or partially/totally excised.
- A graft is inserted to replace or reinforce the artery, with or without a patch graft.
- The incision is closed with sutures or staples.
- The patient is monitored in recovery.
Duration
The procedure typically takes 2-4 hours, depending on its complexity.
Setting
The procedure is performed in a hospital operating room.
Personnel
- Vascular Surgeons
- Anesthesiologists
- Surgical Nurses
- Scrub Technicians
Risks and Complications
- Infection
- Bleeding
- Blood clots
- Damage to surrounding nerves or tissues
- Graft failure or rejection
- Potential need for additional surgeries
Benefits
- Removal or stabilization of the aneurysm or pseudoaneurysm.
- Improved blood flow to the arm.
- Reduction in symptoms and prevention of potential complications like rupture.
Recovery
- Patients are usually hospitalized for a few days post-procedure.
- Pain management will be provided.
- Patients will need to avoid heavy lifting and strenuous activity for several weeks.
- Follow-up appointments to monitor recovery and graft function.
Alternatives
- Endovascular repair, which is less invasive but not always suitable for all aneurysm types.
- Medication management for less severe cases.
- Regular monitoring if surgery is not immediately required.
Patient Experience
- During the procedure, patients will be under anesthesia and not feel anything.
- Post-procedure, patients may experience pain and swelling around the incision site.
- Pain management will be provided, and most discomfort should subside within a few days to weeks.