CPT® Code 33883

Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); initial extension

The CPT® Code 33883 refers to the placement of a proximal extension prosthesis specifically for the endovascular repair of the descending thoracic aorta. This procedure is indicated for various conditions affecting the aorta, including aneurysms, pseudoaneurysms, dissections, penetrating ulcers, intramural hematomas, or traumatic disruptions. The endovascular approach involves accessing the aorta through a puncture in an artery, typically the femoral or iliac artery, allowing for the insertion of a flexible guidewire. This guidewire is navigated retrograde into the ascending aorta, often with the assistance of fluoroscopic guidance, which is a separate reportable service. In some cases, access through the brachial artery may also be necessary to facilitate the placement of the proximal extension components. Once access is established, a second guidewire is introduced through the contralateral femoral or iliac artery, and a sheath is placed to aid in the procedure. An aortogram is performed to assess the proximal aspect of the aneurysm, and measurements are taken using an ultrasound probe to determine the appropriate size for the stent-graft extension prosthesis. The procedure involves careful manipulation of the stent-graft into position, followed by verification of its placement through another aortogram. The deployment of the stent-graft extension prosthesis is critical, as it must be securely attached to the aorta to ensure proper sealing and exclusion of the defect. The procedure concludes with additional imaging to confirm the successful exclusion of the thoracic aorta defect and to check for any potential leakage.