Carotid patch angioplasty (with either a venous or a synthetic patch) may reduce the risk of carotid artery restenosis and subsequent ischaemic stroke. EDITORIAL The role of patch angioplasty carotid endarterectomy Anthony M. Imparato, M.D., New York, N.Y. After It is universally recognized that early. Femoral Endarterectomy. An alternative treatment would be angioplasty with a stent if required. A patch is often used to repair the artery and avoid narrowing. Cardiovasc Surg. 2001 Oct;9(5):458-62. Carotid endarterectomy with bovine patch angioplasty: a preliminary report. Kim GE(1), Kwon TW, Cho YP, Kim DK, Kim HS. Femoral Endarterectomy Removal of plaque from the Femoral Artery When the artery in the groin, the femoral artery, is stenosed or blocked, an operation can be used to remove the plaque from the artery in order to improve flow and circulation. The artery is close to the surface here under the skin, and therefore the surgical procedure is not too invasive. An alternative treatment would be angioplasty with a stent if required. This can be done with access to the arterial system from the opposite groin or arm to perform this. Traditionally the long term results of surgery to remove the plaque when it is localised to the femoral artery have been better than angioplasty. However in certain patient's not suitable for surgery, and with improving technology, angioplasty is being used more frequently. Both treatments can therefore be used, your vascular surgical team will decide which is the best approach for you. The surgical procedure can be performed under general or local anaesthetic. The plaque is removed from the artery. A patch is often used to repair the artery and avoid narrowing. Patient's will stay in hospital 1 or 2 nights following this procedure. Major complications are not common, 2-3%. ![]() Bleeding requiring further surgery, blockage of the artery repair, and infection can occur. The long-term result is often good, with the narrowing in the artery repaired for many years. If there is also disease with narrowed or blocked arteries elswhere above the groin or further down the leg, the endarterectomy operation can be combined with angioplasty and stenting to treat these other areas at the same time. This combined or 'hybrid' procedure is more common now and it achieves a better restoration of the circulation than the endarterectomy procedure alone. I am in need of a reference in ICD-10-CM, that indicates the 'patch graft' is inclusive in with a Carotid endarterectomy with patch angioplasty. A bovine pericardial patch graft was used after the plaque was removed for closure. Is this inclusive in with:? I 03CK0ZZ - Extirpation of Matter from right internal carotid artery, open approach Root Operation: Extirpation is chosen as the intent of the procedure is to remove the plaque from the vein. Extirpation is defined as 'Taking or cutting out solid matter from a body part'. The additional explanation states 'The solid matter may be an abnormal byproduct of a biological function or a foreign body: it may be embedded in a body part or in the lumen of a tubular body part. The solid matter may or may not have been previously broken into pieces.' (PCS Code book Appendix A: Root operations definitions) Body Part: Documentation references 'A longitudinal arteriotomy was then performed, which was extended onto the distal internal carotid artery with the Potts scissors. This did reveal brisk pulsatile backflow from the right internal carotid artery.' Approach: Open due to the 'longitudinal incision was carried through the skin and subcutaneous tissue' and 'longitudinal arteriotomy was then performed, which was extended onto the distal internal carotid artery with the Potts scissors' Thanks, ------------------------------------------- Heather Mitchell Spectrum Health. I use the below guideline to support the fact that you would not assign a code for the patch graft if used to close the arteriotomy site. This is just part of the endarterectomy, The patch graft would not have been performed in and of itself nor was there a particular objective other than to close the site of the arteriotomy. I hope that helps. B3.1b Components of a procedure specified in the root operation definition and explanation are not coded separately. Procedural steps necessary to reach the operative site a nd close the operative site, including anastomosis of a tubular body part, are also not coded separately. Example: Resection of a joint as part of a joint replacement procedure is included in the root operation definition of Replacement and is not coded separately. Laparotomy performed to reach the site of an open liver biopsy is not coded separately. In a resection of sigmoid colon with anastomosis of descending colon to rectum, the anastomosis is not coded separately. 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