CPT® Code 35661

The procedure described by CPT® Code 35661 refers to a bypass graft performed using a synthetic material rather than a vein, specifically a femoral-femoral bypass. This surgical intervention is typically indicated for patients with significant arterial occlusion or stenosis that impairs blood flow in the lower extremities. The procedure involves making incisions in the groin area on both sides, allowing access to the common femoral arteries. Surgeons meticulously dissect the soft tissue to expose these arteries, which are critical for blood supply to the legs. An abdominal tunnel is then created to facilitate the placement of a cross-over graft, which connects one femoral artery to the other, effectively bypassing the obstructed segment. A tubular synthetic graft is selected based on the patient's anatomy and prepared for implantation. The procedure requires clamping of the common femoral artery on the unobstructed side, followed by incision and suturing of the graft to this artery. The graft is then passed through the tunnel to the contralateral femoral artery, which is also clamped and incised for graft attachment. After securing the grafts, vascular clamps are removed, and the surgeon checks for blood flow through the graft using Doppler ultrasound, while also evaluating distal pulses to confirm the patency of the bypass graft. This detailed approach ensures that the graft functions properly, restoring adequate blood circulation to the affected leg.