CPT® Code 34520

A cross-over vein graft to the venous system is a surgical procedure designed to redirect blood flow around obstructed veins in one leg by utilizing healthy veins from the opposite leg. This procedure is particularly beneficial for patients experiencing venous insufficiency or other conditions that lead to obstruction in the venous system. The process begins with an incision made below the area of obstruction on the affected leg, allowing access to the obstructed vein. A second incision is then created in the groin area of the opposite leg, where a subcutaneous tunnel is formed across the suprapubic region and extended along the subsartorial region of the symptomatic leg. This tunneling is essential for positioning the harvested vein without causing additional trauma to the surrounding tissues. The saphenous vein, which is a large vein located in the leg, is carefully dissected from its surrounding tissues on the healthy side, and its tributaries are ligated to prevent blood loss. Once a sufficient length of the saphenous vein is obtained, it is cut at the distal end. The harvested saphenous vein is then tunneled to the site of obstruction on the symptomatic leg. The obstructed vein is clamped and incised below the obstruction, allowing for the creation of an end-to-side anastomosis, which connects the healthy saphenous vein to the obstructed vein, thereby restoring proper blood flow and alleviating symptoms associated with venous obstruction.