CPT® Code 33881

Endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); not involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thoracic aortic extension(s), if required, to level of celiac artery origin

The procedure described by CPT® Code 33881 involves the endovascular repair of the descending thoracic aorta, which is a critical segment of the aorta located in the chest. This procedure is indicated for various conditions affecting the descending thoracic aorta, including aneurysms, pseudoaneurysms, dissections, penetrating ulcers, intramural hematomas, or traumatic disruptions. The endovascular approach allows for less invasive intervention compared to traditional open surgery, as it utilizes catheters and guidewires to navigate through the vascular system. The initial step involves puncturing an access artery, typically the femoral or iliac artery, to introduce a flexible guidewire into the ascending aorta. Fluoroscopic guidance is employed to ensure accurate placement. Following this, a second access point is established in the contralateral femoral or iliac artery, allowing for the introduction of a sheath and a second guidewire. An aortogram is performed to visualize the aneurysm and assess its characteristics. The procedure includes measuring the aneurysm with an ultrasound probe and selecting a properly sized stent-graft (endoprosthesis) for repair. The stent-graft is then maneuvered into position, deployed, and secured using ballooning techniques. If necessary, extensions of the stent-graft are added to reach the level of the celiac artery. Throughout the procedure, multiple aortograms are conducted to confirm the correct positioning of the stent-graft and to ensure complete exclusion of the defect, while also checking for any potential leakage. It is important to note that in this specific code, the repair does not involve coverage of the left subclavian artery origin, distinguishing it from related procedures that may occlude this artery.