CPT® Code 35632

The CPT® Code 35632 refers to a surgical procedure known as a bypass graft, specifically designed for the ilio-celiac region using a synthetic conduit rather than a vein. This procedure is performed to create an alternative pathway for blood flow around a diseased or obstructed segment of the celiac axis, which is crucial for supplying blood to vital organs such as the liver, stomach, esophagus, spleen, and pancreas. The process begins with the exposure and isolation of the common iliac artery, which can be accessed from either the right or left side of the body. The surgical approach involves making an incision in the abdomen, separating the omentum from the transverse colon, and carefully exposing the celiac axis. During the procedure, the arteries branching from the celiac axis, including the hepatic, left gastric, and splenic arteries, are thoroughly evaluated to determine the extent of the obstruction. A synthetic bypass graft of appropriate size is then selected to facilitate the bypass. The surgical team applies vascular clamps to the iliac artery to control blood flow, allowing for a precise incision. The synthetic graft is sutured in an end-to-side configuration to the iliac artery, followed by clamping and incising the celiac artery. The graft is then anastomosed to the celiac artery in a similar end-to-side manner, effectively bypassing the obstructed area. After the clamps are released, the blood flow through the graft is assessed using Doppler ultrasound to ensure proper function and restoration of circulation.