CPT® Code 35515

A subclavian-vertebral bypass graft is a surgical procedure designed to create a new pathway for blood flow around a diseased or obstructed segment of the vertebral artery. This procedure is particularly important in cases where the vertebral artery, which supplies blood to the brain and spinal cord, is compromised due to conditions such as atherosclerosis or other vascular diseases. The surgery involves making an incision at the base of the neck, just above the clavicle, to access the subclavian artery, which is a major blood vessel that branches off the aorta and supplies blood to the arms and parts of the head and neck. The surgical approach may require the division of the clavicle and careful dissection of surrounding muscles, including the anterior scalene muscle, to protect critical structures such as the phrenic nerve. The procedure also involves harvesting a vein graft, often from the saphenous vein in the leg, which is then used to bypass the obstructed area of the vertebral artery. This graft is meticulously sutured to both the subclavian artery and the vertebral artery, ensuring that blood flow is restored. The use of Doppler ultrasound during the procedure allows the surgeon to confirm that blood is flowing properly through the newly created graft.