CPT® Code 35351

Thromboendarterectomy is a surgical procedure specifically targeting the iliac artery, which is a major blood vessel supplying blood to the lower limbs. This procedure is indicated for the removal of thrombus, which can be a blood clot or atherosclerotic plaque that has formed and adhered to the walls of the artery, leading to occlusion. The goal of the thromboendarterectomy is to restore normal blood flow by excising the obstructive material along with the inner layer of the artery, known as the intima. The procedure typically begins with an incision in the abdomen to access the iliac artery, and in cases where the iliofemoral artery is involved, additional incisions may be made in the leg. During the operation, the affected segment of the artery is carefully isolated and dissected from surrounding tissues. To maintain blood flow during the procedure, a temporary shunt may be placed. The surgical team will then clamp the artery above and below the blockage, incise the artery, and meticulously remove the thrombus and plaque. The intima is separated from the arterial wall to enhance the artery's diameter, and the remaining healthy intima is sutured back to the artery wall. Depending on the condition of the artery, the repair may involve direct suturing or the application of a patch graft, which can be either venous or synthetic, to further enlarge the artery's diameter. After the procedure, the shunt is removed, clamps are released to restore blood flow, and the surgical site is closed in layers, ensuring proper hemostasis and recovery of the surrounding tissues.