Oliviamsutton at 15:07, 20 July 2022

2022-07-20T15:07:13Z

← Older revision		Revision as of 08:07, 20 July 2022
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	=== Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> ===		=== Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> ===

			* A-line is always required for frequent ACT draws plus BP management
			* 1-2 18G PIVs

	=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===		=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===

			* GA with ETT due to need for muscle relaxation

	=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===		=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===

			* Supine with arms tucked. C-arm or other fluoro device will be present and obstructing access to patient at times.

	=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===		=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===

			* Muscle relaxation is usually required
			* Heparin should be available and drawn up, as well as syringes for drawing ACTs
			** Protamine should be available but may not always be given.
			* BP should be maintained close to patient's baseline, but always check with the surgeon

	=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===		=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===

			* Avoid hypertension with emergence, which may challenge the new graft and incision. Have downers available to treat temporary HTN, such as labetalol.

	== Postoperative management ==		== Postoperative management ==

	=== Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> ===		=== Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> ===

			* Usually PACU > floor, patients stay 1-2 nights in the hospital

	=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===		=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===

	=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===		=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===

			* Hemorrhage, stroke (embolization due to plaque rupture), groin hematoma

	== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==		== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==

Oliviamsutton: started page

2022-07-20T15:01:28Z

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{{Infobox surgical procedure
| anesthesia_type = GA
| airway = ETT
| lines_access = PIV x1-2, radial a-line (to draw frequent ACTs and monitor BP)
| monitors = Standard
| considerations_preoperative =
| considerations_intraoperative = Have lead available for frequent imaging. Have heparin available and small syringes for ACTs
| considerations_postoperative =
}}

A femoral endarterectomy is a procedure with the goal of restoring patency to an occluded femoral artery and restoring vascular supply to the tissue. It involves a groin incision where the surgeon directly opens the femoral artery and removes the plaque, then closes the artery, at times with a synthetic patch.

== Overview ==

=== Indications ===
Partial or total occlusion of the femoral artery from atherosclerosis and/or PAD.

=== Surgical procedure ===

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Airway
|
|-
|Neurologic
|
|-
|Cardiovascular
|Most of these patients have significant PAD. Many of these patients have comorbid CAD, HTN
|-
|Pulmonary
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studies ===

=== Operating room setup ===

=== Patient preparation and premedication ===

=== Regional and neuraxial techniques ===

== Intraoperative management ==

=== Monitoring and access ===

=== Induction and airway management ===

=== Positioning ===

=== Maintenance and surgical considerations ===

=== Emergence ===

== Postoperative management ==

=== Disposition ===

=== Pain management ===

=== Potential complications ===

== Procedure variants ==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

== References ==

[[Category:Surgical procedures]]

Femoral artery endarterectomy - Revision history

Oliviamsutton at 15:07, 20 July 2022

Oliviamsutton: started page