CPT® Code 35518

An axillary-axillary bypass graft is a surgical procedure designed to create a new pathway for blood flow around a diseased or obstructed segment of the axillary artery located on the opposite side of the body. This procedure is particularly relevant in cases where the axillary artery has become narrowed or blocked, which can lead to reduced blood flow to the arm and shoulder. The surgery involves making a skin incision just below the clavicle, allowing the surgeon to access the axillary artery. Through careful dissection of the surrounding soft tissue, the proximal end of the first axillary artery is exposed. This process is mirrored on the contralateral side to prepare for the grafting. A tunnel is then created across the chest to connect the two axillary arteries. A vein graft, often harvested from the saphenous vein in the leg, is utilized to facilitate this bypass. The harvesting of the vein involves making an incision in the leg, dissecting the vein from surrounding tissues, and ligating its branches before removing the necessary segment. Once the vein graft is prepared, it is sutured to the first axillary artery, passed through the tunnel, and then attached to the second axillary artery. The procedure concludes with the removal of vascular clamps and verification of blood flow through the graft using Doppler ultrasound, along with an assessment of distal pulses to ensure the bypass graft is functioning properly.