CPT® Code 35001

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, carotid, subclavian artery, by neck incision

The CPT® Code 35001 refers to the surgical procedure for the direct repair of an aneurysm or pseudoaneurysm, as well as the excision (either partial or total) and graft insertion, which may include the use of a patch graft. This procedure specifically targets the carotid or subclavian artery and is performed through a neck incision. An aneurysm is characterized by an abnormal enlargement or dilation of an artery, which can arise from various causes such as arteriosclerosis, mechanical obstructions like thoracic outlet syndrome, or malposition of the artery. Less frequently, aneurysms may be caused by infections such as syphilis or tuberculosis, or by structural abnormalities of the vessel wall, such as fibromuscular dysplasia. In contrast, a pseudoaneurysm is a condition that does not involve all three layers of the artery wall and is often the result of trauma—either blunt or penetrating—or complications from medical procedures, such as catheterization. This results in a pulsating hematoma that is encapsulated and communicates directly with the artery wall. The surgical approach for this procedure may involve harvesting a saphenous vein graft from the lower leg if necessary. The operation begins with an incision in the neck, and in cases involving the subclavian artery, a portion of the clavicle may be excised to enhance access. Careful dissection of the overlying soft tissues is performed while protecting critical structures such as the phrenic nerve. The underlying artery is then exposed, and necessary clamping is done to control blood flow. The aneurysm sac is opened, and any thrombus or plaque is removed before the artery walls are repaired and a graft is applied as needed. This procedure is classified as nonemergent and elective, distinguishing it from similar procedures that may be performed in emergency situations, such as the repair of a ruptured aneurysm.