CPT® Code 35695

The procedure described by CPT® Code 35695 involves the surgical transposition and/or reimplantation of the carotid artery to the subclavian artery. This complex vascular surgery is typically performed to address specific anatomical or pathological conditions that may necessitate the rerouting of blood flow between these two major arteries. The procedure begins with a supraclavicular incision at the base of the neck, allowing the surgeon access to the subclavian and carotid arteries. During the operation, the clavicular head is incised, and the scalene fat pad is mobilized and reflected superiorly to expose the underlying structures. Care is taken to identify and protect critical anatomical components, such as the phrenic nerve and the vagus nerve, which are essential for maintaining normal physiological function. The surgical steps involve meticulous dissection of the arteries to ensure that they are free from surrounding tissues, which is crucial for the success of the anastomosis. The procedure may also involve the preservation or ligation of the thoracic duct, depending on the specific circumstances encountered during surgery. The creation of a tunnel behind the sternocleidomastoid muscle and jugular vein facilitates the repositioning of the arteries. The use of systemic anticoagulants is standard practice to prevent thromboembolic complications during the procedure. Ultimately, the end of the carotid artery is sutured to the side of the subclavian artery, establishing a new pathway for blood flow. This procedure is critical in managing conditions that affect blood supply and can significantly impact patient outcomes.