CPT® Code 35492

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The CPT® Code 35492 refers to a specific medical procedure known as transluminal peripheral atherectomy, which is performed percutaneously on the iliac artery. This procedure is designed to remove plaque buildup from the arterial walls, thereby improving blood flow. The term "percutaneous" indicates that the procedure is performed through the skin, typically involving a small incision or puncture. In this case, the access point is usually one of the femoral arteries, which are located in the groin area. The procedure begins with the preparation of the skin over the access artery, followed by puncturing the artery with a needle to insert a sheath. A guidewire is then introduced and advanced into the occluded iliac artery, allowing for the subsequent placement of an atherectomy catheter. This specialized catheter is equipped with a cutting piston that effectively shaves away plaque from the arterial wall as it is advanced. The plaque is collected within the device and removed upon completion of the procedure. The physician may perform multiple passes with the atherectomy device to ensure thorough plaque removal. After the atherectomy, an angiography catheter is used to inject contrast material and perform a completion angiography, which confirms that the artery is open and blood flow is restored. Finally, pressure is applied to the puncture site to control any bleeding, and a pressure dressing is applied to promote healing.