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Ligation of femoral vein
CPT4 code
Name of the Procedure:
Ligation of Femoral Vein
Common names: Femoral Vein Ligation
Technical term: Femoral Vein Ligation and Division
Summary
Ligation of the femoral vein is a surgical procedure where a surgeon ties off, or ligates, the femoral vein to prevent blood flow. This is usually done to treat severe varicose veins, blood clots, or venous reflux.
Purpose
The procedure addresses conditions like deep vein thrombosis (DVT), severe varicose veins, or venous insufficiency. The goal is to prevent complications such as pulmonary embolism, chronic leg swelling, and leg ulcers by reducing abnormal blood flow and pressure in the affected veins.
Indications
- Severe varicose veins
- Deep vein thrombosis (DVT)
- Chronic venous insufficiency
- Venous stasis ulcers
- Recurrent ulcers despite conservative treatment
Preparation
- Fasting for at least 8 hours before the procedure.
- Stopping certain medications like blood thinners, as advised by the doctor.
- Preoperative blood tests and ultrasounds to evaluate vein structure and blood flow.
- Physical examination and medical history review.
Procedure Description
- Anesthesia: General or regional anesthesia is administered.
- Incision: A small incision is made in the groin area to access the femoral vein.
- Ligation: The femoral vein is carefully separated from surrounding tissues, and surgical ligatures (ties) are placed around the vein to close it off.
- Closure: The incision is then closed with sutures or surgical staples, and a sterile dressing is applied.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
The procedure is usually performed in a hospital operating room.
Personnel
- Vascular or general surgeon
- Anesthesiologist
- Surgical nurses
- Physician assistants or surgical technicians
Risks and Complications
- Infection at the incision site
- Bleeding or hematoma formation
- Deep vein thrombosis (DVT) in adjacent veins
- Nerve damage or numbness in the leg
- Pulmonary embolism (rare)
- Allergic reactions to anesthesia
Benefits
- Reduced risk of blood clots traveling to the lungs (pulmonary embolism)
- Alleviation of symptoms like pain and swelling
- Prevention of further complications like skin ulcers
- Improved quality of life
Recovery
- Hospital stay of 1-2 days post-procedure.
- Keep the leg elevated and minimize movement for the first few days.
- Gradual return to normal activities over 2-4 weeks.
- Follow-up appointments for wound inspection and removal of stitches if non-absorbable.
- Compression stockings may be advised.
Alternatives
- Medical management with medications (e.g., blood thinners)
- Non-surgical treatments like compression therapy
- Endovenous laser treatment (EVLT)
- Sclerotherapy
- Each alternative has its own set of benefits and risks; surgical intervention is considered when other treatments fail or are inappropriate.
Patient Experience
- Patients will be under anesthesia during the procedure and won’t feel any pain.
- Postoperatively, there may be discomfort or soreness at the incision site, managed with pain medications.
- Gradual improvement of symptoms as healing occurs.
- Regular follow-ups to monitor recovery and manage any complications.