CPT® Code 33370

Add-On Code

Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (List separately in addition to code for primary procedure)

The procedure described by CPT® Code 33370 involves the transcatheter placement and subsequent removal of cerebral embolic protection devices. These devices are critical in capturing and removing thrombus debris, which significantly reduces the risk of stroke during procedures such as transcatheter aortic valve replacement or implantation. The presence of embolic debris poses a continuous threat of stroke for patients undergoing these cardiovascular interventions. To ensure patient safety, appropriate anticoagulation therapy is administered prior to the procedure. The process begins with imaging of the aortic arch to assess the anatomy and plan for access. Typically, the right radial or brachial artery is evaluated for patency, with the right radial artery being the preferred access point. An introducer sheath is then placed to facilitate the delivery of the embolic protection device. This device consists of two filters: the proximal filter is positioned in the brachiocephalic artery, while the distal filter is placed in the left common carotid artery. A guidewire is utilized to navigate the deployment system into the appropriate locations under fluoroscopic guidance. The procedure requires careful monitoring and verification of the filters' positions to ensure they are correctly seated and functioning as intended. The filters are designed to be retrieved at the end of the procedure, with a maximum indwelling time of 90 minutes to minimize the risk of complications.