35633 Bypass graft, with other than vein; ilio-mesenteric

Name of the Procedure:

Bypass graft, with other than vein; ilio-mesenteric

Summary

This procedure involves creating a bypass around blocked or narrowed arteries in the iliac and mesenteric regions using a graft made from materials other than veins, often synthetic or other biological tissues. It helps restore proper blood flow to critical areas of the pelvis and intestines.

Purpose

The procedure addresses arterial blockages or severe narrowing in the iliac or mesenteric arteries, which supply blood to the pelvis and intestines. The goal is to improve blood flow, alleviate symptoms such as pain and digestive issues, and prevent severe complications like tissue damage or organ failure.

Indications

• Severe atherosclerosis causing narrowing or blockage of the iliac or mesenteric arteries.
• Chronic mesenteric ischemia.
• Symptoms like intermittent claudication, rest pain, or postprandial abdominal pain.
• Failure of other treatment options such as medication or angioplasty.
• Critical limb ischemia.

Preparation

• Fasting for at least 8 hours before the procedure.
• Adjusting current medications, especially blood thinners, as advised by the doctor.
• Undergoing pre-procedure tests, including blood work, imaging studies (e.g., CT angiography), and an overall health assessment.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made near the blocked artery in the iliac and mesenteric regions.
3. A synthetic graft or a graft from another source is prepared.
4. The graft is attached to healthy segments of the artery above and below the blockage, bypassing the problem area.
5. Blood flow is redirected through the new graft, restoring adequate circulation.
6. The incision is closed, and surgical dressings are applied.

Duration

The procedure typically takes 3 to 5 hours.

Setting

The procedure is performed in a hospital's surgical suite or operating room.

Personnel

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

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma formation.
• Blood clots leading to graft occlusion.
• Damage to nearby organs or tissues.
• Graft rejection or failure.
• Adverse reactions to anesthesia.

Benefits

• Restoration of proper blood flow to the affected areas.
• Relief from symptoms like pain and digestive issues.
• Prevention of severe complications such as tissue damage or organ failure.
• Improved quality of life and functional status.

Recovery

• Hospital stay of around 5 to 7 days post-procedure.
• Pain management with prescribed medications.
• Gradual resumption of normal activities over 4 to 6 weeks.
• Instructions to avoid strenuous activities and heavy lifting.
• Follow-up appointments for monitoring graft function and overall recovery.

Alternatives

• Medication management to control symptoms and progression of blockages.
• Endovascular procedures like angioplasty and stenting.
• Surgical options like endarterectomy to remove blockages directly.

Patient Experience

• The patient will be under general anesthesia and will not feel pain during the procedure.
• Post-procedure, some discomfort and soreness at the incision site can be expected.
• Pain management strategies will be provided.
• Gradual improvement in symptoms should be noticed within a few weeks of recovery.