CPT® Code 34706

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 rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption)

The CPT® Code 34706 refers to the endovascular repair procedure of the infrarenal aorta and/or iliac artery(ies) utilizing an aorto-bi-iliac endograft. This procedure is critical in managing vascular conditions such as aneurysms, pseudoaneurysms, dissections, penetrating ulcers, and traumatic disruptions. The endograft is a specialized device made from a non-permeable polyester material, supported by a self-expanding flexible metal frame, designed to reinforce the weakened sections of the aorta and iliac arteries. The aorto-bi-iliac endograft consists of a main body that fits into the aorta and two tapered limbs that extend into the iliac arteries, which can be either a unibody or modular design. During the procedure, a guidewire is introduced into the abdominal aorta through the femoral artery or the distal external iliac arteries, allowing for precise placement of the endograft. Fluoroscopic guidance is employed to ensure accurate positioning of the endograft below the renal arteries. The deployment process involves partially releasing the endograft, ensuring that the upper aortic end is correctly positioned to create a secure seal. In cases where a modular endograft is used, a second guidewire is introduced to facilitate the deployment of the contralateral limb, which is anchored to the vessel wall with a stent to prevent leakage. The procedure may also include angioplasty and stenting to enhance the repair and ensure a tight seal at the junctions of the graft and the native vessels. In emergency situations, such as a rupture, the procedure may involve temporary balloon occlusion to control hemorrhage while the endograft is being deployed. This comprehensive approach to endovascular repair is essential for reducing the risk of further complications and stabilizing the patient’s condition.