CPT® Code 35490

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The CPT® Code 35490 refers to a specific medical procedure known as transluminal peripheral atherectomy, which is performed percutaneously on the renal or other visceral arteries. This procedure is designed to remove plaque buildup from the arterial walls, thereby restoring blood flow to the affected areas. The term "transluminal" indicates that the procedure is conducted within the lumen of the artery, while "percutaneous" signifies that it is performed through the skin, typically using a minimally invasive approach. The procedure often begins with the preparation of the skin over the access artery, which is usually one of the femoral arteries. A needle is then used to puncture the artery, and a sheath is placed to facilitate access. A guidewire is inserted and navigated into the occluded artery, allowing for the advancement of an atherectomy catheter. This specialized catheter is equipped with a cutting piston that effectively shaves away plaque from the arterial wall. The removed plaque is collected within the device and expelled upon completion of the procedure. The physician may perform multiple passes with the atherectomy device to ensure thorough plaque removal. Following the atherectomy, an angiography catheter is utilized to confirm the patency of the artery through contrast injection and imaging. The procedure concludes with measures to control bleeding at the puncture site, ensuring patient safety and recovery.