CPT® Code 34705

Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer)

The CPT® Code 34705 refers to the endovascular repair of the infrarenal aorta and/or iliac artery(ies) utilizing an aorto-bi-iliac endograft. This procedure is primarily indicated for conditions such as aneurysms, pseudoaneurysms, dissections, or penetrating ulcers, rather than for ruptured vessels. The endograft is a sophisticated medical device made from a non-permeable polyester material, which is reinforced by a self-expanding flexible metal frame. The design of the aorto-bi-iliac endograft includes a main body that fits within the aorta and tapered limbs that extend into the iliac arteries, which can be either a unibody or modular configuration. During the procedure, a guidewire is inserted into the abdominal aorta through the femoral artery or the distal external iliac arteries. The endograft is then carefully positioned below the renal arteries using fluoroscopic imaging to ensure accurate placement. The deployment process involves partially releasing the endograft, ensuring that the upper aortic end is correctly positioned to create a secure seal with the non-aneurysmal aortic neck and the iliac artery. In cases where a modular endograft is used, a second guidewire is introduced through the contralateral iliac artery to facilitate the deployment of the contralateral limb of the endograft. The procedure also includes angioplasty and stenting as necessary to ensure a tight fit and prevent any potential leakage around the graft. Following the deployment, the sheaths and guidewires are removed, and the femoral arteries are repaired. This endovascular approach is crucial for managing vascular conditions effectively, as it minimizes the risk of complications associated with open surgical procedures and promotes quicker recovery times for patients.