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

1. The patient is given anesthesia for comfort, usually general anesthesia.
2. An incision is made in the arm to access the axillary-brachial artery.
3. The aneurysm or pseudoaneurysm is identified.
4. Depending on the aneurysm's condition, it may be repaired directly, or partially/totally excised.
5. A graft is inserted to replace or reinforce the artery, with or without a patch graft.
6. The incision is closed with sutures or staples.
7. 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.