35650 Bypass graft, with other than vein; axillary-axillary

Name of the Procedure:

Axillary-Axillary Bypass Graft (Non-Vein)

Summary

An axillary-axillary bypass graft involves creating an alternative pathway for blood flow between the axillary arteries in each arm using a synthetic graft material, rather than a vein.

Purpose

This procedure is performed to improve blood flow for patients with certain vascular conditions, such as blockages or narrowed arteries, which can help relieve symptoms like severe arm fatigue or pain and reduce the risk of more serious complications.

Indications

• Severe atherosclerosis or other arterial blockages in the upper extremity arteries
• Symptoms such as arm pain, weakness, or fatigue
• Failed prior attempts at less invasive treatments

Preparation

• Fasting typically required for at least 8 hours before the procedure
• Adjustment or pause in certain medications, especially blood thinners
• Preoperative imaging tests, such as Doppler ultrasound or angiography, to map the arteries

Procedure Description

1. Anesthesia: Given under general anesthesia.
2. Incision: Small incisions made under each arm to access the axillary arteries.
3. Graft Placement: A synthetic graft is carefully tunneled under the skin and connected to the axillary artery of the other arm.
4. Connection: Both ends of the graft are anastomosed (surgically connected) to each axillary artery.
5. Closure: Incisions are closed with sutures or staples.
6. Monitoring: Blood flow through the graft is checked to ensure it's functioning correctly.

Duration

The procedure typically takes around 2 to 4 hours.

Setting

Performed in a hospital operating room.

Personnel

• Vascular surgeon
• Surgical nurse
• Anesthesiologist
• Operating room technician

Risks and Complications

• Infection at the incision sites
• Blood clots
• Graft failure
• Bleeding complications
• Anesthesia-related risks

Benefits

• Improved blood flow to the arms
• Relief of symptoms like pain and fatigue
• Potential reduction in risk of further vascular complications

Recovery

• Hospital stay of 1-3 days post-procedure for monitoring
• Pain management with prescribed medications
• Instructions on caring for the incision sites
• Gradual return to normal activities over 4-6 weeks
• Follow-up appointments to check graft function

Alternatives

• Endovascular treatments (e.g., angioplasty, stenting)
• Medications to manage symptoms
• Conservative management with lifestyle changes

Patient Experience

• During the procedure: No awareness or pain due to general anesthesia
• After the procedure: Soreness and discomfort at the incision sites
• Pain management through prescribed medications
• Gradual improvement in symptoms over the recovery period