CPT® Code 36224

Selective catheter placement, internal carotid artery, unilateral, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch, when performed

Selective catheter placement in the internal carotid artery is a specialized medical procedure that involves the insertion of a catheter into the artery to facilitate diagnostic imaging and assessment of the carotid circulation. This procedure is typically performed unilaterally, meaning it targets either the right or left internal carotid artery. The process begins with a percutaneous approach, which is a minimally invasive technique that allows access to the artery through the skin. Common access points for this procedure include the femoral, axillary, brachial, or radial arteries, with the femoral artery being the most frequently used due to its accessibility and the direct route it provides to the aorta. During the procedure, a small incision is made at the chosen insertion site, and an introducer sheath is placed into the artery. A guidewire is then navigated through the vascular system, allowing for the advancement of the catheter into the aortic arch and subsequently into the targeted carotid artery. Once positioned correctly, radiopaque contrast media is injected to enhance the visibility of the blood vessels during imaging. This enables the physician to perform angiography of both the extracranial and intracranial carotid circulation, providing critical information about the blood flow and any potential abnormalities. The procedure also includes comprehensive radiological supervision and interpretation, ensuring that all findings are accurately documented for further analysis and treatment planning.