CPT® Code 35876

Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula); with revision of arterial or venous graft

An open thrombectomy of an arterial or venous graft, excluding hemodialysis grafts or fistulas, is a surgical procedure aimed at removing a thrombus, or blood clot, that has formed within the graft. This procedure may be performed with or without the need to revise the graft itself. Following the placement of an arterial or venous graft, complications such as stenosis, which is a narrowing of the graft, can occur, leading to thrombosis and subsequent re-occlusion. In such cases, an open surgical approach is necessary to directly access the graft and remove the thrombus. The procedure begins with an incision made over the graft site, allowing the surgeon to place vessel loops both proximal and distal to the thrombus to manage blood flow effectively. The graft is then opened, and the thrombus is removed through direct exposure. Techniques such as applying arterial back pressure or manual massage may be utilized to facilitate the expulsion of the clot. After the thrombus is successfully removed, angiography may be conducted to confirm that the graft is patent and that all clot material has been eliminated. If stenosis is present, a revision of the graft may be required, which could involve enlarging the narrowed area with a patch graft or excising and replacing it with a tubular graft segment. It is important to differentiate this procedure from CPT® Code 35875, which is used when an open thrombectomy is performed without any revision of the graft.