Name of the Procedure:

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, radial or ulnar artery.

• Common Names: Aneurysm repair, arterial graft repair, pseudoaneurysm surgery.

Summary

This surgical procedure involves the direct repair of an aneurysm or pseudoaneurysm in the radial or ulnar artery. It may also include the partial or total removal of the affected artery segment and the insertion of a graft, with or without a patch graft, to restore normal blood flow.

Purpose

The procedure addresses aneurysms (ballooning of the artery) or pseudoaneurysms (false aneurysms) and associated occlusive disease in the radial or ulnar arteries. The goal is to prevent rupture, restore adequate blood flow, and alleviate symptoms associated with occluded or weakened arterial walls.

Indications

• Symptoms include pain, swelling, or a pulsatile mass in the radial or ulnar artery area.
• Presence of an aneurysm or pseudoaneurysm confirmed by imaging studies.
• Occlusive disease causing restricted blood flow.

Preparation

• Patients may need to fast for several hours before the procedure.
• Pre-procedure imaging studies such as an ultrasound, CT scan, or MRI to assess the aneurysm.
• Blood tests and a physical examination.
• Adjustment of certain medications as instructed by the physician.

Procedure Description

1. Anesthesia: The patient receives local or general anesthesia.
2. Incision: A surgical incision is made over the affected artery.
3. Repair or Excision: The aneurysm or pseudoaneurysm is identified and repaired or excised. If excised, a graft is used to replace the removed section.
4. Graft Placement: A vascular graft, possibly with a patch, is inserted to restore artery integrity.
5. Closure: The incision is closed with sutures or staples.
   • Tools: Surgical clamps, graft materials, sutures.
   • Anesthesia: Local or general, depending on the case specifics.

Duration

The procedure typically takes between 2 to 4 hours, depending on the complexity and extent of the repair.

Setting

This surgery is generally performed in a hospital operating room.

Personnel

• Vascular surgeon
• Surgical nurses
• Anesthesiologist
• Surgical technician

Risks and Complications

• Infection at the incision site.
• Blood clots or bleeding.
• Graft rejection or failure.
• Nerve damage in the surgical area.
• Complications related to anesthesia.

Benefits

• Prevents aneurysm rupture.
• Restores normal blood flow.
• Reduces symptoms and risk of severe complications.

Recovery

• Hospital stay of 1-3 days for monitoring.
• Pain management with prescribed medications.
• Instructions on wound care and activity restrictions.
• Follow-up appointments to monitor healing and graft function.
• Recovery time typically spans several weeks, with gradual return to normal activities.

Alternatives

• Non-surgical management with medications to control symptoms.
• Endovascular repair as a minimally invasive alternative.
• Observation and routine monitoring for small, asymptomatic aneurysms.
• Pros and cons vary based on the specific patient condition and the aneurysm size and location.

Patient Experience

• During the procedure: The patient will be under anesthesia and will not feel pain.
• After the procedure: Some discomfort at the incision site, which can be managed with pain medication.
• Expect mild to moderate pain initially, improving over time.
• Guidelines on pain management, wound care, and activity levels provided by the healthcare team.