Name of the Procedure:

Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula); with revision of arterial or venous graft.

Summary

A thrombectomy involves removing a clot (thrombus) from an artery or vein. This specific thrombectomy targets grafts placed in arteries or veins (excluding hemodialysis grafts or fistulas). During the procedure, the surgeon may also revise or repair the graft to ensure proper blood flow.

Purpose

This procedure is performed to restore normal blood flow in grafts that have become blocked by clots. By removing the clot and revising the graft if needed, the procedure aims to prevent tissue damage and other complications associated with restricted blood flow.

Indications

• Blocked arterial or venous grafts causing reduced blood flow.
• Symptoms such as pain, swelling, or tissue damage due to the blocked graft.
• Graft malfunctions identified through diagnostic imaging or clinical assessment.

Preparation

• Patients may be required to fast for a certain period before the procedure.
• Medication adjustments, such as pausing blood thinners under medical advice.
• Pre-procedure diagnostic tests, such as imaging studies (e.g., ultrasound, angiography) and blood tests.

Procedure Description

1. The patient is positioned, and the surgical site is prepped and sterilized.
2. Anesthesia (local, regional, or general) is administered depending on the specifics of the case.
3. An incision is made to access the graft.
4. Using specialized tools, the clot is removed from the graft.
5. The surgeon may then revise or repair the graft to ensure proper blood flow.
6. The incision is closed, and bandages are applied.

Tools used may include catheters, balloons, and other thrombectomy devices.

Duration

Typically, the procedure lasts between 1 to 3 hours, depending on the complexity.

Setting

This procedure is usually performed in a hospital, often within a dedicated surgical suite or specialized interventional radiology unit.

Personnel

• Vascular or cardiovascular surgeon
• Surgical nurses
• Anesthesiologist
• Possibly interventional radiologists or other specialized technicians

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma formation.
• Re-occlusion or formation of new clots.
• Damage to the vessels or graft.
• Adverse reactions to anesthesia.

Benefits

• Restoration of normal blood flow in the affected graft.
• Prevention of complications like tissue damage or necrosis.
• Improved symptoms and overall vascular health.

Recovery

• Patients may need to stay in the hospital for observation.
• Pain management with prescribed medications.
• Instructions on wound care, activity limitations, and monitoring for signs of complications.
• Follow-up appointments for further assessment and imaging if needed.

Alternatives

• Medical management with anticoagulants or thrombolytic medications.
• In some cases, less invasive procedures like angioplasty.
• Replacing the graft entirely.

Patient Experience

• Patients might experience discomfort or pain during recovery, which is managed with medications.
• Continuous monitoring and support during the hospital stay.
• Gradual resumption of normal activities based on the physician's advice.
• Regular follow-up to track recovery progress and assess graft function.