35141 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, common femoral artery (profunda femoris, superficial femoral)

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 of the common femoral artery (profunda femoris, superficial femoral). Commonly referred to as "Femoral Artery Aneurysm Repair."

Summary

Femoral Artery Aneurysm Repair is a surgical procedure to fix a weakened or ballooned area in the femoral artery. The operation involves removing the aneurysm or pseudoaneurysm and repairing the artery by inserting a graft, which helps restore normal blood flow.

Purpose

This procedure addresses aneurysms or pseudoaneurysms in the femoral artery, which can lead to severe complications if left untreated. The goals are to prevent rupture, relieve symptoms, and restore proper blood circulation in the leg.

Indications

• Presence of a diagnosed aneurysm or pseudoaneurysm in the femoral artery.
• Associated occlusive disease of the common, profunda femoris, or superficial femoral arteries.
• Symptoms such as pain, swelling, or ischemia due to the aneurysm.
• Risk of rupture or thrombosis.

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Medication adjustments, such as stopping blood thinners, may be necessary.
• Pre-procedure imaging tests (e.g., ultrasound, CT scan, MRI) to assess the aneurysm.
• A thorough medical evaluation, including blood tests and a physical exam.

Procedure Description

1. Anesthesia: The patient is placed under general anesthesia for comfort and pain management.
2. Incision: A surgical incision is made near the site of the aneurysm.
3. Exposure: The femoral artery is carefully exposed and isolated.
4. Excision: The aneurysm or pseudoaneurysm is partially or totally excised.
5. Repair: A graft (synthetic or autologous) is inserted into the artery, with or without a patch graft, to repair the vessel and restore blood flow.
6. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.
7. Monitoring: Blood flow is checked to ensure the repair is successful.

Duration

The procedure typically takes 2 to 4 hours, depending on the complexity of the aneurysm and individual patient factors.

Setting

The procedure is performed in a hospital operating room under sterile conditions.

Personnel

• Vascular surgeons
• Anesthesiologists
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection at the incision site.
• Bleeding or hematoma formation.
• Thrombosis or embolism.
• Graft rejection or failure.
• Damage to surrounding tissues or nerves.
• Anesthesia-related complications.

Benefits

• Prevents rupture of the aneurysm.
• Relieves symptoms such as pain and swelling.
• Restores normal blood flow to the leg.
• Lowers the risk of complications like thrombosis.

Recovery

• Immediate post-operative care includes monitoring in the recovery room.
• Pain management with prescribed medications.
• Gradual return to normal activities within 1-2 weeks, avoiding strenuous activities.
• Follow-up appointments to monitor healing and vascular health.
• Lifestyle modifications, such as diet and exercise, may be recommended.

Alternatives

• Endovascular repair, which involves using a stent to reinforce the artery (minimally invasive).
• Medical management with medications and monitoring (non-surgical).
• Pros and cons: Endovascular repair has a shorter recovery time but may not be suitable for all aneurysms, whereas medical management doesn't address the structural defect.

Patient Experience

• During the procedure: Patients are unconscious and pain-free due to general anesthesia.
• After the procedure: Some post-operative pain and discomfort, managed with medication.
• Important to follow care instructions to ensure proper healing and avoid complications.
• Regular follow-up is crucial to monitor recovery and long-term vascular health.