35266 Repair blood vessel with graft other than vein; upper extremity

Name of the Procedure:

Repair Blood Vessel with Graft Other Than Vein; Upper Extremity
Common Names: Vascular grafting, Bypass grafting for arm

Summary

This procedure involves repairing a damaged blood vessel in the upper arm using a graft that is not a vein. The graft helps restore blood flow and maintain proper circulation in the affected limb.

Purpose

This procedure addresses blood vessel damage due to injury, aneurysm, or severe atherosclerosis. The goal is to restore adequate blood flow to the arm, reduce pain, and prevent tissue damage or loss due to insufficient blood supply.

Indications

• Severe arm pain or cramping during activity
• Coldness or numbness in the arm
• Non-healing wounds on the arm or hand
• Previous unsuccessful treatments for blood vessel issues
• Diagnostic imaging showing significant vascular blockage or damage

Preparation

• Fast for at least 8 hours before the procedure
• Adjust or stop certain medications as advised by your doctor
• Undergo pre-procedure imaging tests like ultrasound, MRI, or CT scans
• Provide a detailed medical history and list of medications

Procedure Description

1. The patient is administered general anesthesia.
2. The surgeon makes an incision in the upper arm to access the damaged blood vessel.
3. The damaged portion of the blood vessel is removed or bypassed.
4. A synthetic or biologic graft (other than a vein) is used to replace or bypass the damaged section.
5. The graft is sutured in place to ensure a secure fit and proper blood flow.
6. The incision is closed with sutures and a sterile dressing is applied.

Tools and Technology: Surgical instruments, graft material (synthetic or biologic), imaging equipment for guidance.
Anesthesia: General anesthesia is typically used.

Duration

The duration of the procedure is usually 2 to 4 hours, depending on the complexity.

Setting

The procedure is performed in a hospital surgical suite.

Personnel

• Vascular Surgeon
• Anesthesiologist
• Surgical Nurses
• Surgical Technicians

Risks and Complications

• Common Risks: Infection, bleeding, graft rejection or failure.
• Rare Risks: Blood clot formation, nerve damage, long-term swelling, complications from anesthesia.
• Management: Regular monitoring and medications to prevent infection or clots, follow-up appointments.

Benefits

• Improved blood flow to the upper extremity
• Reduced pain and cramping
• Enhanced healing of wounds
• Prevention of further tissue damage
• Benefits typically realized within weeks following recovery

Recovery

• Hospital stay of 1-3 days post-procedure
• Instructions to keep the arm elevated and limit movement
• Pain management with prescribed medications
• Wound care and follow-up appointments within 1-2 weeks
• Physical therapy might be recommended
• Full recovery may take several weeks to a few months

Alternatives

• Medications such as blood thinners or vasodilators
• Angioplasty with or without stent placement
• Endovascular repair techniques
• Pros: Less invasive options may have quicker recovery
• Cons: May not be as effective in severe cases

Patient Experience

• During: The patient will be under general anesthesia and unaware of the procedure.
• After: Initial discomfort and pain managed with medications
• Expect some bruising and swelling at the incision site
• Gradually improving arm function with reduced pain and better circulation
• Follow-up visits to monitor graft success and overall recovery progress.