CPT® Code 36831

The procedure described by CPT® Code 36831 refers to an open thrombectomy performed on an arteriovenous (AV) fistula, which is a surgical connection between an artery and a vein. This procedure is necessary when a thrombus, or blood clot, forms within the AV fistula, leading to occlusion and impaired blood flow. The thrombectomy is conducted without any revision of the fistula itself and can involve either autogenous (using the patient's own tissue) or nonautogenous (using synthetic materials) dialysis grafts. The process begins with an incision made over the AV fistula, allowing the surgeon to access the affected blood vessels. Once exposed, vessel loops are strategically placed to control blood flow, enabling the surgeon to safely open the artery, vein, or graft to remove the thrombus. Techniques such as applying arterial back pressure or manual massage may be employed to facilitate the expulsion of the clot. After the thrombus is successfully removed, a completion angiography may be performed to verify that the clot has been entirely cleared and that the AV fistula remains patent, ensuring proper function for future dialysis treatments.