CPT® Code 33891

Bypass graft, with other than vein, transcervical retropharyngeal carotid-carotid, performed in conjunction with endovascular repair of descending thoracic aorta, by neck incision

The procedure described by CPT® Code 33891 involves a bypass graft using a synthetic conduit, specifically performed in the transcervical retropharyngeal region between the carotid arteries. This surgical intervention is typically indicated for patients requiring vascular reconstruction in conjunction with an endovascular repair of the descending thoracic aorta. The operation begins with a bilateral incision in the neck, allowing for careful dissection to expose the carotid arteries while ensuring the protection of surrounding vessels and nerves. The common carotid arteries are then controlled using soft rubber loops to facilitate the surgical process. A tunnel is created behind the pharynx to enable the passage of the synthetic conduit, which is essential for establishing the bypass. Throughout the procedure, anticoagulation is administered intravenously to prevent thromboembolic complications. The surgical steps include clamping, incising, and anastomosing the common carotid arteries to the bypass conduit, followed by meticulous control of bleeding and verification of blood flow. The procedure concludes with the closure of the neck incisions, ensuring a secure and effective surgical outcome.