CPT® Code 35112

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, splenic artery

The procedure described by CPT® Code 35112 involves the direct surgical repair of a ruptured splenic artery aneurysm or pseudoaneurysm, which may also include the excision of the affected area and the insertion of a graft, with or without the use of a patch graft. An aneurysm is characterized by an abnormal enlargement or dilation of an artery, which can occur due to various factors such as arteriosclerosis, mechanical obstruction, or malposition of the artery. Less frequently, aneurysms may arise from conditions like syphilis, tuberculosis, or abnormalities in the vessel wall, such as fibromuscular dysplasia. In contrast, a pseudoaneurysm is defined as a hematoma that forms in direct communication with the artery wall but does not involve all three layers of the arterial wall, distinguishing it from a true aneurysm. Pseudoaneurysms often result from trauma—either blunt or penetrating—or as a complication from medical procedures, such as catheterization. Specific causes of splenic artery pseudoaneurysms can include pancreatitis, septic emboli, or arteritis. The splenic artery itself originates from the celiac trunk, which branches off from the abdominal aorta just below the diaphragm. The surgical approach for this procedure typically involves harvesting a saphenous vein graft from the lower leg if needed, followed by a midline abdominal, transverse, or retroperitoneal flank incision to access the splenic artery. The procedure is critical in emergency situations where a ruptured aneurysm poses a significant risk of hemorrhage, necessitating immediate intervention to control bleeding and repair the artery.