CPT® Code 35693

The procedure described by CPT® Code 35693 involves the surgical transposition and/or reimplantation of the vertebral artery to the subclavian artery. This complex vascular surgery is performed to address issues related to the vertebral artery, which may include redundancy or other anatomical variations that necessitate repositioning for improved blood flow. The procedure begins with an incision in the neck to expose the vertebral artery, allowing the surgeon to assess its length and condition. A systemic anticoagulant is administered intravenously to prevent clotting during the procedure. The surgeon then identifies the appropriate site on the subclavian artery for anastomosis, which is the surgical connection between the two blood vessels. The redundant portion of the vertebral artery is carefully clamped and divided above any stenosis or occlusion, ensuring that the healthy segment can be effectively reimplanted. The vertebral artery is then brought into proximity with the subclavian artery, where it is anastomosed in an end-to-side fashion. This meticulous process is crucial for restoring adequate blood flow, and prior to closing the incision, the vessels are backbled to ensure proper circulation is re-established. This procedure is essential for patients who may experience compromised blood flow due to anatomical variations or vascular conditions affecting the vertebral artery and its connection to the subclavian artery.