Name of the Condition

• Other Atherosclerosis of Unspecified Type of Bypass Graft(s) of the Extremities, Bilateral Legs
• ICD-10 Code: I70.393

Summary

Atherosclerosis in bypass grafts of the legs is a condition where arteries, surgically created or altered as a result of previous procedures, become narrowed or blocked due to the buildup of fatty deposits. It specifically involves grafts in both legs where the type of graft is not specified.

Causes

Atherosclerosis can develop due to prolonged exposure to unhealthy lifestyle factors, such as high cholesterol, high blood pressure, and smoking, which lead to plaque buildup in arterial walls. It can also be a progression of existing coronary artery disease that affects vascular grafts.

Risk Factors

• Age, particularly those over 50
• Family history of cardiovascular diseases
• Smoking
• Diabetes
• Hypertension
• High cholesterol levels
• Obesity

Symptoms

• Pain or cramping in the legs while walking or exercising (claudication)
• Weak or absent pulse in legs or feet
• Slow healing wounds or sores on feet or legs
• Discoloration of legs
• Coldness in the lower leg or foot, especially compared with the other leg

Diagnosis

• Physical examination focusing on pulse and blood flow in extremities
• Ankle-brachial index (ABI) to compare blood pressure in the ankle and arm
• Duplex ultrasound
• Magnetic Resonance Angiography (MRA)
• Computed Tomography Angiography (CTA)

Treatment Options

• Medications: Cholesterol-lowering drugs to manage lipid levels, antiplatelet agents to prevent clots, and blood pressure medications.
• Lifestyle changes: Diet and exercise to improve cardiovascular health.
• Surgical procedures: Angioplasty or stent placement to maintain open grafts, bypass surgery in severe cases where new grafts are needed.

Prognosis and Follow-Up

• With appropriate treatment and lifestyle adjustments, patients can manage symptoms effectively.
• Regular monitoring is necessary to check for progression or recurrence.
• Compliance with medications and follow-up appointments with healthcare providers is crucial for a favorable outcome.

Complications

• Critical limb ischemia
• Increased risk of heart attack or stroke
• Graft failure requiring additional surgical intervention
• Gangrene if blood flow is severely restricted

Lifestyle & Prevention

• Adopt a heart-healthy diet low in saturated fats and cholesterol.
• Engage in regular physical activity.
• Quit smoking and avoid exposure to tobacco.
• Maintain a healthy weight and manage conditions like diabetes and hypertension.

When to Seek Professional Help

• Sudden or severe leg pain
• Non-healing wounds or ulcers on the legs or feet
• Symptoms of stroke or heart attack, such as chest pain or numbness in the arms or face

Additional Resources

• American Heart Association (heart.org)
• Peripheral Artery Disease (PAD) Coalition (padcoalition.org)

Tips for Medical Coders

• Ensure the precise identification of bilateral leg involvement and use of unspecified type of graft in coding.
• Double-check patient history for previous grafts or bypass surgeries.
• Avoid assuming specifics about the type of graft without explicit medical records.