CPT® Code 35331

Thromboendarterectomy is a surgical procedure aimed at removing a thrombus, which can be a blood clot or atherosclerotic plaque, from the abdominal aorta or other major arteries such as the mesenteric, celiac, or renal arteries. This procedure is essential for restoring blood flow in cases where these arteries have become occluded due to the buildup of plaque or clots that adhere to the vessel walls. The process begins with an incision in the abdomen to access the affected blood vessel. Once exposed, the thrombosed section is carefully isolated and dissected from surrounding tissues. To maintain blood flow during the procedure, a temporary shunt may be placed. Vascular clamps are then applied both proximal and distal to the obstruction, allowing the surgeon to incise the artery and remove the thrombus along with the intima, which is the inner lining of the artery. This removal increases the diameter of the vessel, facilitating better blood flow. After the thrombus and intima are excised, the remaining edges of the normal intima are sutured back to the artery walls. The artery is then repaired, either through primary suturing or by using a patch graft, which can be made from venous or synthetic material to further enlarge the vessel's diameter. Once the repair is complete, any temporary shunts are removed, clamps are released to restore blood flow, and the surgical site is closed in layers to ensure proper healing.