CPT® Code 35525

A brachial-brachial bypass graft is a surgical procedure designed to create an alternative pathway for blood flow around a diseased or obstructed segment of the brachial artery, which is located in the upper arm. This procedure is performed on the same side of the body where the obstruction occurs, ensuring that blood can continue to flow effectively to the arm and hand. The process begins with the surgeon making a skin incision over the proximal (closer to the center of the body) portion of the brachial artery, followed by a second incision over the distal (further from the center) section of the artery. This allows the surgeon to access the artery directly and create a tunnel between the two incision sites. To facilitate the bypass, a vein graft is harvested, typically from the saphenous vein in the leg. The harvesting involves making an incision in the leg, dissecting the soft tissue away from the vein, and carefully ligating and dividing its branches. The selected segment of the vein is then ligated at both ends, cut, and removed for use in the graft. Once the vein graft is prepared, vascular clamps are applied to the proximal brachial artery to control blood flow, and an incision is made in the artery. The vein graft is then sutured to the proximal end of the brachial artery and passed through the tunnel created earlier. The distal brachial artery is similarly clamped and incised, allowing the other end of the vein graft to be sutured in place. After the clamps are removed, the surgeon checks for proper blood flow through the graft using Doppler ultrasound and evaluates distal pulses to confirm the bypass graft's patency, ensuring that blood is flowing correctly to the arm and hand.