CPT® Code 35879

An open revision of a lower extremity arterial bypass, as described by CPT® Code 35879, involves a surgical procedure aimed at correcting issues that may arise in a previously established arterial bypass graft. This procedure is specifically performed without thrombectomy, which means that the removal of a blood clot is not part of this operation. Instead, vein patch angioplasty is utilized to address complications such as stenosis, which is a narrowing of the graft, inflow artery, or outflow artery that can lead to reduced blood flow and potential graft failure. The procedure begins with an incision made over the affected area of the bypass graft, allowing the surgeon to access and expose the graft. During the operation, vessel loops are strategically placed to control blood flow, ensuring a clear working area. A segment of vein, typically harvested from the saphenous vein, is prepared to create a patch that will be used to augment the narrowed segment of the graft. This patch is then sutured into place, effectively increasing the diameter of the stenosed area and improving blood flow through the graft. Following the completion of the patching, vessel loops are released, and a completion angiography is performed to confirm that the revised segment of the arterial graft is patent, meaning it is open and functioning properly. This procedure is critical for maintaining the patency of arterial bypass grafts and ensuring adequate blood supply to the lower extremities.