35701 Exploration not followed by surgical repair, artery; neck (eg, carotid, subclavian)

Name of the Procedure:

Exploration not followed by surgical repair, artery; neck
Common Names: Carotid artery exploration, Subclavian artery exploration

Summary

In this procedure, a surgeon explores the arteries in the neck, such as the carotid or subclavian arteries, to diagnose and evaluate potential issues but does not perform surgical repair during the same procedure.

Purpose

This procedure addresses concerns like narrowing, blockages, or other abnormalities of the neck arteries. The goal is to identify problems that could impede blood flow to the brain and other areas, potentially preventing strokes or other vascular issues.

Indications

• Symptoms suggestive of artery disease, such as transient ischemic attacks (TIA) or stroke.
• Abnormal imaging studies (e.g., CT, MRI, or ultrasound) indicating artery problems.
• Patients with risk factors for vascular diseases, such as high blood pressure, high cholesterol, or diabetes.

Preparation

• Fasting may be required for at least 8 hours before the procedure.
• Medication adjustments may be necessary, including blood thinners.
• Pre-procedure imaging tests (e.g., ultrasound, CT scan) to provide detailed views of the arteries.

Procedure Description

1. The patient is positioned and prepped in the operating room.
2. Anesthesia is administered (usually general anesthesia).
3. The surgeon makes an incision in the neck to access the artery.
4. The artery is carefully exposed and examined visually and sometimes with imaging or other diagnostic tools.
5. Detailed evaluation of the artery is performed to identify any blockages, narrowing, or anomalies.
6. No surgical repair or intervention is done during this procedure.
7. The incision is closed with sutures, and a dressing is applied.

Duration

The procedure typically takes around 1 to 2 hours.

Setting

This procedure is usually performed in a hospital or a specialized surgical center.

Personnel

• Vascular surgeon or general surgeon with vascular training
• Anesthesiologist
• Surgical nurses and possibly scrub techs

Risks and Complications

• Common risks: Infection, bleeding, blood clots, and bruising.
• Rare risks: Nerve damage, allergic reactions to anesthesia, stroke, and damage to the artery.

Benefits

• Detailed diagnostic information about the artery condition.
• Helps plan for future interventions if needed.
• May prevent complications by timely identification of arterial problems.

Recovery

• Typically requires a short hospital stay (1-2 days).
• Post-procedure care includes wound care, monitoring for complications, and possibly starting blood thinners or other medications.
• General recovery time is a few days to a couple of weeks, with follow-up appointments to monitor progress.

Alternatives

• Non-invasive imaging tests like CT angiography or MRI angiography.
• Direct surgical intervention or endovascular procedures if impractical or if diagnosis and treatment are necessary in one go.
• Pros: Non-invasive alternatives are less risky and involve shorter recovery times.
• Cons: They may not provide as detailed information or allow for immediate intervention.

Patient Experience

• During the procedure: The patient will be under general anesthesia and won’t feel anything.
• After the procedure: The patient may experience soreness in the neck and mild discomfort, which can be managed with pain medication.
• Pain management includes prescribed pain relief, and comfort measures include elevating the head to reduce swelling.