#### Name of the Condition
- **Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, bilateral legs** (ICD I70.413)
- Often referred to as "Peripheral artery disease (PAD) with graft atherosclerosis" or "Intermittent claudication after vein graft surgery."

#### Summary
- This condition involves the narrowing and hardening of vein grafts used in bypass surgery of the legs due to plaque buildup, leading to reduced blood flow and causing leg pain during walking, known as intermittent claudication.

#### Causes
- Atherosclerosis, primarily caused by plaque buildup in the blood vessels.
- Previous surgical procedures using vein grafts to bypass blocked arteries in the legs.

#### Risk Factors
- Age and gender (more common in older adults and males).
- High cholesterol, high blood pressure, diabetes, smoking, and sedentary lifestyle.
- History of heart disease or previous vascular surgeries.

#### Symptoms
- Pain or cramping in both legs during physical activities such as walking or climbing stairs.
- Symptoms are typically alleviated with rest.

#### Diagnosis
- Physical examination and assessment of medical history.
- Doppler ultrasound, Ankle-Brachial Index (ABI), or angiography to assess blood flow and the condition of the grafts.

#### Treatment Options
- Medications such as antiplatelets and statins to manage symptoms and plaque buildup.
- Lifestyle modifications, including exercise and dietary changes.
- Surgical options like angioplasty or additional bypass operations in severe cases.

#### Prognosis and Follow-Up
- With appropriate management, symptoms can be improved and the progression of the disease can be slowed.
- Regular follow-ups with a vascular specialist to monitor graft health and adjust treatment plans as needed.

#### Complications
- Increased risk of heart attack, stroke, and critical limb ischemia if not managed properly.
- Possible graft failure necessitating further surgical intervention.

#### Lifestyle & Prevention
- Implementing a heart-healthy diet low in saturated fats and cholesterol.
- Regular physical activity tailored to abilities, like walking programs.
- Smoking cessation and managing diabetes, blood pressure, and cholesterol levels.

#### When to Seek Professional Help
- Sudden increase in leg pain, numbness, or weakness.
- Development of severe ulcers or wounds on the legs or feet that don’t heal.

#### Additional Resources
- American Heart Association: [www.heart.org](https://www.heart.org)
- Vascular Disease Foundation: [www.vasculardisease.org](https://www.vasculardisease.org)

#### Tips for Medical Coders
- Verify that the condition is specific to bilateral leg grafts and involves intermittent claudication.
- Ensure correct use of accompanying codes for hypertension, diabetes, or lipid disorders if applicable.
- Avoid coding errors by distinguishing between native artery atherosclerosis and vein graft arteriosclerosis.

This markdown guide provides a structured overview of the condition for both medical professionals and individuals seeking to understand atherosclerosis in vein grafts of the extremities.