CPT® Code 35538

A bypass graft, specifically coded as CPT® 35538, involves the surgical creation of a new pathway for blood flow around a diseased or obstructed segment of the lower aorta, extending to one or both iliac arteries. This procedure utilizes a vein that is harvested either from the patient’s own body or from a donor. The surgical approach typically begins with a lower abdominal incision, which allows the surgeon to access and expose the aorta. Once the aorta is visible, clamps are applied above the area of obstruction to control blood flow during the procedure. In some cases, the aorta may be tied off above the obstructed section to facilitate the attachment of the vein graft. The harvested vein graft is then sutured to the aorta, creating an anastomosis, which is a surgical connection between two structures. To ensure the integrity of this connection, a vessel clamp is placed on the venous graft while the aortic clamp is released, allowing the surgeon to check for any leaks at the anastomosis site. Following this, the iliac artery is clamped distal to the anastomosis site, and through a separate incision, the other end of the vein graft is sutured into the iliac artery. This step is crucial as it completes the bypass route, allowing blood to flow past the obstructed area of the aorta. The surgeon will again check for leaks and ensure the patency of the graft before closing the abdominal incision. This procedure is essential for restoring adequate blood flow to the lower extremities when the aorta is compromised.