Thromboendarterectomy, including patch graft, if performed; each additional tibial or peroneal artery (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Thromboendarterectomy; Including Patch Graft, if Performed; Each Additional Tibial or Peroneal Artery
Summary
Thromboendarterectomy is a surgical procedure to remove blood clots and atherosclerotic plaque from the walls of tibial or peroneal arteries. Often, a patch graft is also used to repair the artery. This additional procedure is typically done following a primary thromboendarterectomy in another artery.
Purpose
Thromboendarterectomy aims to restore proper blood flow in arteries blocked by clots or plaque buildup. This procedure is vital for improving circulation to avoid ischemia and related complications like tissue death.
Indications
- Significant blockage in tibial or peroneal arteries causing pain or risk of tissue damage.
- Peripheral artery disease.
- Non-healing wounds due to poor blood circulation.
- Symptoms like claudication (muscle pain due to inadequate blood flow).
Preparation
- Fasting for at least 8 hours prior to the procedure.
- Discontinuing certain medications, as advised by the doctor.
- Blood tests and imaging studies (e.g., Doppler ultrasound, angiography) to assess the extent of arterial blockage.
Procedure Description
- The patient is given regional or general anesthesia.
- An incision is made to access the affected artery.
- Blood clots and plaque are carefully removed from the artery.
- If necessary, a patch graft is placed to repair the artery and ensure it remains open.
- The incision is closed, and blood flow is restored.
Duration
The procedure typically takes 2 to 3 hours, depending on the complexity.
Setting
Performed in a hospital operating room.
Personnel
- Vascular surgeon
- Anesthesiologist
- Surgical nurses and technicians
Risks and Complications
- Infection
- Bleeding
- Blood clots
- Artery damage
- Anesthesia-related risks
- Re-narrowing of the artery (restenosis)
Benefits
- Improved blood flow and oxygen supply to tissues.
- Reduced pain and risk of complications from poor circulation.
- Enhanced wound healing capabilities.
Recovery
- Hospital stay for 1-2 days post-procedure.
- Monitoring for any immediate complications.
- Pain management and wound care instructions.
- Follow-up appointments to check on recovery and effectiveness of the procedure.
- Gradual return to normal activities, typically within a few weeks.
Alternatives
- Angioplasty and stenting.
- Bypass surgery.
- Medication management.
- Lifestyle changes such as diet and exercise.
Pros of Thromboendarterectomy: Direct removal of blockage, immediate improvement in blood flow. Cons: Surgical risks and longer recovery time compared to less invasive procedures.
Patient Experience
During the procedure, the patient is under anesthesia and will not feel pain. Post-procedure, discomfort or pain at the incision site can be managed with medications. Blood flow improvement can be noticed shortly after recovery, although some soreness and restrictions on activity are expected during the initial healing phase.