CPT® Code 35355

Thromboendarterectomy is a surgical procedure specifically targeting the iliac or iliofemoral arteries, which are critical blood vessels supplying blood to the lower extremities. This procedure is primarily indicated for the removal of thrombi, which are blood clots, or atherosclerotic plaques that have formed on the inner walls of these arteries, leading to occlusion and impaired blood flow. The procedure involves making an incision in the abdomen to access the iliac artery, and in cases involving the iliofemoral artery, an additional incision in the leg is necessary to adequately expose the affected area. During the operation, the surgeon isolates the thrombosed segment of the artery, carefully dissecting it from surrounding tissues. To ensure continuous blood flow during the procedure, a temporary shunt may be placed. The surgical technique includes clamping the artery above and below the blockage, incising the artery, and meticulously removing the thrombus and any plaque. The intima, which is the innermost layer of the artery, is also removed to enhance the artery's diameter, facilitating improved blood flow. The procedure concludes with the suturing of the artery, either primarily or with the use of a patch graft, followed by the removal of the shunt and clamps, and ensuring hemostasis before closing the incision layers. This comprehensive approach aims to restore normal blood circulation and alleviate symptoms associated with arterial occlusion.