CPT® Code 35458

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The procedure described by CPT® Code 35458 involves an open transluminal balloon angioplasty specifically targeting the brachiocephalic trunk or its branches. This intervention is performed to alleviate blockages within these critical blood vessels, which are responsible for supplying blood to the arms and head. The process begins with the preparation of the skin over the access artery, followed by an incision to expose the artery. Once the artery is accessed, a small nick is made, and a sheath is inserted to facilitate further procedures. A guidewire is then introduced and navigated through the artery into the brachiocephalic trunk or its branches. A catheter equipped with a balloon tip is advanced over this guidewire to the site of the occlusion. The balloon is inflated, which compresses the plaque against the arterial wall, thereby widening the vessel and restoring blood flow. This inflation may be repeated multiple times to achieve optimal results. After the angioplasty, the catheter is exchanged for a guidewire, and an angiography catheter is used to perform a completion angiography, ensuring that the vessel remains patent after the procedure. Finally, the angiography catheter is removed, the access artery is repaired, and the skin incision is closed. It is important to note that the code 35458 should be used for each vessel treated during this procedure.