CPT® Code 36226

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

The CPT® Code 36226 refers to a specific medical procedure known as selective catheter placement in the vertebral artery on a unilateral basis. This procedure involves the insertion of a catheter into the vertebral artery, which is a critical vessel supplying blood to the brain. The process begins with the placement of a catheter through a percutaneous approach, typically via the femoral, axillary, brachial, or radial artery, with the retrograde femoral artery approach being the most commonly utilized method. During the procedure, a small incision is made at the insertion site, and an introducer sheath is placed into the artery. A guidewire is then navigated through the arterial system, allowing for the advancement of the catheter into the aortic arch and subsequently into the targeted vertebral artery. The procedure is performed under continuous fluoroscopic guidance to ensure accurate placement of the catheter. Once the catheter is positioned appropriately, radiopaque contrast media is injected to visualize the blood flow through the vertebral circulation. This angiography may also include imaging of the cervicocerebral arch, providing a comprehensive view of the vascular structures involved. The procedure encompasses all necessary radiological supervision and interpretation, ensuring that the findings are documented and communicated effectively. The completion of the procedure involves the removal of the catheter and achieving hemostasis at the arteriotomy site, which is crucial for patient safety and recovery.