CPT® Code 34833

Add-On Code

Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral (List separately in addition to code for primary procedure)

The procedure described by CPT® Code 34833 involves the surgical exposure of the iliac artery, which is a major blood vessel located in the pelvis. This exposure is achieved through an abdominal or retroperitoneal incision, allowing the surgeon to create a conduit. The conduit serves two primary purposes: it facilitates the delivery of an endovascular prosthesis for the repair of aortic or iliac defects, or it establishes a pathway for cardiopulmonary bypass. The creation of a conduit is particularly important when direct cannulation of the iliac artery is not advisable due to anatomical considerations or the patient's condition. During the procedure, the surgeon carefully incises the skin in the lower abdomen or retroperitoneum and meticulously dissects through the tissue to access the iliac artery, ensuring the protection of surrounding structures such as veins, nerves, and the ureter. The procedure requires precise dissection of arterial branches, with bleeding controlled through ligation or electrocautery. The iliac artery is then freed from surrounding tissue over a length of 5-6 cm and secured with vessel loops to maintain its position. Following this, the artery is clamped and incised to allow for the tailored conduit to be anastomosed to it. This conduit may be utilized for various surgical interventions, including the establishment of cardiopulmonary bypass, which is critical in certain cardiac procedures. The entire process is performed unilaterally and is reported separately in addition to the primary procedure, highlighting its significance in complex vascular surgeries.