Popliteal Artery Entrapment Decompression


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ughh this one has me stumped!

I am finding plenty of research articles on it, but no hints how to code it. This closest I am finding is a decompression fasciotomy.

I would so appreciate all help!

1. Right popliteal artery entrapment decompression.
2. De-insertion of right medial head of gastrocnemius and reinsertion
to right tenderness medial condyle

An S-shaped incision was then made overlying the
popliteal fossa on the right. The fascia was then opened in the same
pattern. We then exposed the popliteal fat pad which was dissected
exposing the gastrocnemius muscle. We immediately noted that the medial
head of gastrocnemius muscle was inserted into the lateral femoral
condyle. The popliteal artery traveled underneath the medial head of
the gastrocnemius muscle and then made up to the popliteal vein between
the medial and lateral heads. The popliteal vein in the nerve ran over
the top of the head of the tendinous insertion of the medial
gastrocnemius muscle and had not been compressed. There was
additionally a fibrous band of tissue overlying the popliteal artery as
it traversed underneath the gastrocnemius muscle. Initially, the
popliteal artery was decompressed by transecting this dense fibrous
tissue. Then, the medial head of the gastrocnemius muscle was incised
at its tendinous insertion to the lateral condyle. This released the
medial head which were then able to rotate back to the medial side of
the popliteal vessels. The medial head of the gastrocnemius was then
reinserted on to the tendon, medial condyle with 2-0 Vicryl suture.
We reinspected the position of the popliteal artery in the popliteal
vein and a good normal anatomic position with no compression was noted.
Hemostasis was observed and the wound was then irrigated with normal
saline and antibiotic containing solution. The fascia of the posterior
fossa was then reapproximated medial and laterally with 2-0 Vicryl
suture. A portion of the fossa was left open in the mid portion of the
wound. A 3-0 Vicryl suture was then used to place deep subcutaneous
tissue, stitches in an interrupted fashion. The skin was then closed
with a 4-0 Vicryl in a subcuticular fashion. Dermabond, Steri-Strips
and a dry fluff dressing was placed.


Heather Shaw, CPC, CIRCC