Repair blood vessel, direct; upper extremity
CPT4 code
Name of the Procedure:
Repair of Blood Vessel, Direct (Upper Extremity); also known as Direct Vascular Repair of the Upper Limb.
Summary
This procedure involves the surgical repair of a damaged blood vessel in the upper extremity, which includes the arms and hands. It is performed to restore normal blood flow and function to the affected area.
Purpose
This procedure addresses conditions such as vascular trauma, aneurysms, or blood vessel blockages in the upper extremity. The goal is to re-establish proper circulation, alleviate symptoms, prevent tissue damage, and avoid potential complications like limb loss.
Indications
- Trauma or injury to blood vessels in the arm or hand
- Aneurysms or abnormal bulging of blood vessels
- Arterial blockages causing poor circulation
- Symptoms such as severe pain, swelling, discoloration, or loss of function in the limb
Preparation
- Patients may be advised to fast for several hours before the procedure.
- Medication adjustments, such as stopping blood thinners, may be required.
- Pre-procedure diagnostic tests like Doppler ultrasound, angiography, or CT scans to locate the damaged vessel.
Procedure Description
- The patient is given anesthesia, which may be local, regional, or general, depending on the case.
- A surgical incision is made near the damaged blood vessel.
- The surgeon directly repairs the vessel using techniques like suturing or grafting with a synthetic or autologous graft.
- Blood flow is restored through the repaired vessel.
- The incision is closed with sutures or staples, and the area is bandaged.
Tools and equipment may include vascular clamps, sutures, grafts, and surgical instruments specific to vascular surgery.
Duration
The procedure typically lasts between 1 to 3 hours, depending on the extent of the repair needed.
Setting
This procedure is usually performed in a hospital operating room or a specialized surgical center.
Personnel
- Vascular Surgeon
- Anesthesiologist
- Surgical Nurses
- Surgical Technicians
Risks and Complications
Common risks:
- Bleeding
- Infection
- Blood clots
Rare but serious complications:
- Damage to surrounding nerves or tissues
- Graft failure
- Recurrence of vascular issues
Benefits
- Restoration of normal blood flow
- Alleviation of pain and other symptoms
- Prevention of tissue damage and potential limb loss Benefits are typically realized soon after the procedure, with significant improvements in circulation and function.
Recovery
- Monitoring in a recovery room immediately after the procedure.
- Pain management with medications.
- Instructions for wound care and maintaining the cleanliness of the surgical site.
- Expected recovery time varies; most patients can resume normal activities within a few weeks.
- Follow-up appointments to monitor the success of the repair and overall vascular health.
Alternatives
- Endovascular repair: less invasive but may not be suitable for all cases.
- Conservative management with medications and lifestyle changes, depending on the severity of the condition. Pros of alternatives include lower risk and shorter recovery time, but they may not be as effective for severe or acute injuries.
Patient Experience
During the procedure:
- Patients will be under anesthesia and should not feel pain.
After the procedure:
- Mild to moderate pain at the incision site, managed with medications.
- Possible discomfort or swelling as the area heals.
- Instructions for mobility and activity restrictions to ensure proper healing. Comfort measures include pain relief medications and elevation of the limb to reduce swelling.