CPT® Code 35013

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, axillary-brachial artery, by arm incision

The CPT® Code 35013 refers to the surgical procedure for the direct repair of an aneurysm or pseudoaneurysm, specifically targeting the axillary-brachial artery through an incision in the arm. An aneurysm is characterized by an abnormal enlargement or dilation of an artery, which can arise from various causes, including arteriosclerosis, mechanical obstructions like thoracic outlet syndrome, or abnormalities in the vessel wall such as fibromuscular dysplasia. Pseudoaneurysms, on the other hand, differ from true aneurysms as they do not involve all three layers of the arterial wall and are often the result of trauma or complications from medical procedures, leading to a pulsating hematoma that communicates with the artery wall. The procedure involves either direct repair or excision of the aneurysm, with the potential insertion of a graft, which may be autogenous (using the patient's own saphenous vein) or synthetic. The surgical approach requires careful exposure of the axillary-brachial artery, clamping to control blood flow, and meticulous repair of the artery walls, ensuring that any thrombus or plaque is removed. The procedure is performed in an emergency setting, particularly for ruptured aneurysms, necessitating immediate isolation and control of bleeding before the repair can be completed.