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Ligation; external carotid artery

CPT4 code

Name of the Procedure:

Ligation of the External Carotid Artery
Common names: External Carotid Artery Ligation, ECA Ligation

Summary

Ligation of the external carotid artery is a surgical procedure where the artery is tied off to prevent blood flow. This is done to manage severe bleeding or reduce blood supply to certain areas.

Purpose

Medical Conditions: Severe bleeding from head or neck injuries, certain head and neck tumors
Goals: Stop excessive bleeding, reduce blood supply to tumors, minimize complications

Indications

  • Uncontrolled hemorrhage in the head or neck region
  • Recurrent nosebleeds (epistaxis) unresponsive to other treatments
  • Certain types of head and neck cancers where reducing blood supply can aid in treatment

Preparation

  • Fasting for 8-12 hours prior to the procedure
  • Discontinuation of certain medications (e.g., blood thinners)
  • Pre-operative imaging (CT scan, MRI, or angiography)
  • Blood tests and overall health assessment

Procedure Description

  1. Anesthesia: Typically performed under general anesthesia
  2. Incision: A small cut is made in the neck to access the external carotid artery
  3. Ligation: The artery is carefully isolated and tied off with sutures or a surgical clip to halt blood flow
  4. Closure: The incision is closed with sutures or staples
  5. Post-operation: Monitoring of vitals and surgical site for any immediate complications

Tools: Scalpel, sutures, surgical clips, forceps, hemostats
Technology: Intraoperative imaging may be used to guide the procedure

Duration

The procedure usually takes about 1-2 hours.

Setting

Performed in a hospital operating room.

Personnel

  • Surgeon: Performs the procedure
  • Anesthesiologist: Manages anesthesia
  • Surgical nurses: Assist during the surgery
  • Scrub technicians: Prepare and manage surgical instruments

Risks and Complications

  • Common: Infection, bleeding, pain at the incision site
  • Rare: Stroke, accidental damage to nearby nerves or blood vessels, recurrence of bleeding
  • Management: Monitoring, medications, possibly further surgery

Benefits

  • Expected Outcomes: Immediate control of severe bleeding, reduction of blood supply to tumors, stabilization of the patient's condition
  • Realization: Benefits are typically seen immediately post-procedure

Recovery

  • Post-procedure Care: Monitoring in the hospital, pain management, antibiotics to prevent infection
  • Recovery Time: Generally, a few days to a week
  • Restrictions: Avoid heavy lifting and strenuous activities for several weeks; follow-up appointments for wound check and additional treatments

Alternatives

  • Non-surgical: Embolization, medication management
  • Pros: Less invasive, quicker recovery for non-surgical options
  • Cons: May be less effective in controlling severe bleeding or reducing tumor blood supply

Patient Experience

  • During: Under general anesthesia, so the patient will be asleep and feel no pain
  • After: Possible pain and swelling at the incision site, managed with pain medications; discomfort should decrease over several days

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