CPT® Code 35495

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The CPT® Code 35495 refers to a specific medical procedure known as transluminal peripheral atherectomy, which is performed percutaneously on the tibioperoneal trunk and its branches. This procedure is primarily indicated for patients with occlusions in the peripheral arteries, particularly in the lower extremities. The process begins with the preparation of the skin over the access artery, typically one of the femoral arteries, where a puncture is made using a needle. Following this, a sheath is inserted to facilitate access to the arterial system. A guidewire is then introduced and navigated through the access artery into the occluded segment of the artery. The atherectomy catheter, which is specifically designed for this procedure, is advanced over the guidewire, and the guidewire is subsequently withdrawn. The atherectomy device employs a specialized balloon catheter that features a window on one side, allowing a cutting piston to be advanced. This cutting piston effectively shaves plaque from the arterial wall, with the shaved plaque being directed into the nose of the atherectomy device for removal upon completion of the procedure. The physician may perform multiple passes with the atherectomy device to ensure optimal results in clearing the occlusion. Once the atherectomy is completed, the device is exchanged for an angiography catheter, through which contrast material is injected. This step is crucial as it allows for a completion angiography to be performed, ensuring that the artery remains patent after the procedure. Finally, the angiography catheter is withdrawn, and pressure is applied to the arterial puncture site to control any bleeding, followed by the application of a pressure dressing to secure the site. This comprehensive approach aims to restore blood flow in the affected arteries while minimizing complications and ensuring patient safety.