35286 Repair blood vessel with graft other than vein; lower extremity

Name of the Procedure:

Repair blood vessel with graft other than vein; lower extremity

Summary

This procedure involves repairing a damaged or blocked blood vessel in the lower extremity by using a graft from a source other than a vein.

Purpose

The procedure is used to address issues such as severe artery damage or blockages in the lower extremities. The goal is to restore normal blood flow and prevent complications such as tissue damage or limb loss.

Indications

• Severe peripheral artery disease (PAD)
• Traumatic injury to the blood vessel in the lower extremity
• Aneurysms or clot formation in the lower extremity arteries
• Non-responsive conditions to other treatments like medication or lifestyle changes

Preparation

• Patients may need to fast for 8-12 hours prior to the procedure.
• Adjustments to current medications may be necessary, particularly blood thinners.
• Pre-procedure diagnostic tests such as angiography, ultrasound, or blood tests will be conducted.

Procedure Description

1. The patient is given anesthesia—general or regional.
2. An incision is made at the site of the damaged blood vessel.
3. A synthetic graft or a graft from another part of the body (other than vein) is prepared.
4. The graft is sewn into place, bypassing the damaged or blocked segment of the blood vessel.
5. The incision is closed with sutures or staples.
6. The area is bandaged and monitored for proper blood flow.

Duration

The procedure typically takes 2-4 hours depending on the complexity.

Setting

Performed in a hospital's surgical theater.

Personnel

• Vascular surgeon
• Anesthesiologist
• Surgical nurses
• Possibly a surgical technician

Risks and Complications

• Infection at the incision site
• Blood clots
• Reaction to anesthesia
• Bleeding or hemorrrhage
• Graft rejection or failure
• Nerve damage

Benefits

• Restoration of normal blood flow to the lower extremity
• Reduction in symptoms such as pain and cramping
• Prevention of tissue damage and loss of limb
• Most benefits realized shortly after recovery

Recovery

• Hospital stay for 1-3 days post-procedure.
• Pain management with medications.
• Instructions for wound care and physical activity restrictions.
• Follow-up appointments to monitor graft functionality.
• Recovery time varies, but normal activities can usually be resumed within a few weeks.

Alternatives

• Medication and lifestyle changes for less severe cases.
• Angioplasty and stent placement.
• Use of vein graft instead of synthetic or other graft materials.
• Pros and cons vary with less invasive options posing less risk but potentially lower effectiveness for severe cases.

Patient Experience

• The patient will be asleep if general anesthesia is used or may feel minimal discomfort with regional anesthesia.
• Some post-operative pain or discomfort is common.
• Pain management includes medication and rest.
• Gradual return to normal activities with specific post-op care and lifestyle advice.