CPT® Code 0553T

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Percutaneous transcatheter placement of iliac arteriovenous anastomosis implant, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention

The CPT® Code 0553T refers to the procedure of percutaneous transcatheter placement of an iliac arteriovenous anastomosis implant. This innovative intervention is designed to create a direct connection, or conduit, between the high-pressure external iliac artery and the high-capacity external iliac vein. The primary purpose of this procedure is to lower blood pressure in patients who suffer from treatment-resistant hypertension, a condition that does not respond adequately to standard antihypertensive therapies. The procedure is performed in an endovascular catheterization lab, utilizing fluoroscopic guidance to ensure precision and safety throughout the intervention. A small incision is made in the upper thigh or inguinal area, allowing access to the iliac vein. A needle is carefully used to puncture the anterior wall of the iliac vein, followed by the insertion of a deployment catheter that contains a self-expanding nitinol coupler device. This device is advanced through the needle and catheter at a specific angle to facilitate its placement into the iliac artery. Once positioned correctly, the implant is deployed, creating an open channel between the artery and vein, which is crucial for managing blood pressure effectively. After the successful deployment of the implant, both the catheter and needle are withdrawn, and the incision site is closed, completing the procedure.