CPT® Code 36834

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The CPT® Code 36834 refers to the plastic repair of an arteriovenous (AV) aneurysm, which is classified as a separate procedure. An arteriovenous aneurysm is an abnormal dilation or bulging of a blood vessel that occurs at the site where an artery and a vein are connected, often as a result of repeated punctures or trauma to the AV fistula. This condition can lead to complications such as increased pressure within the fistula, which may further exacerbate the aneurysm formation. In some cases, the presence of proximal stenosis, or narrowing of the blood vessel upstream, can contribute to the development of an aneurysm by elevating the pressure in the AV fistula. To assess the condition of the AV fistula and the aneurysm, a fistulogram may be performed, which is a diagnostic imaging procedure that helps visualize the blood vessels and identify any stenosis or multiple aneurysms that may be present. The surgical procedure for repairing the aneurysm involves making a longitudinal incision over the aneurysm site while carefully avoiding puncturing the aneurysm itself. The surgeon dissects the aneurysm and completes the skeletonization, which involves isolating the aneurysm from surrounding tissues. Vascular clamps are then applied both proximal and distal to the aneurysm to control blood flow, allowing for the reduction of the aneurysm size. The wall of the aneurysm sac is subsequently plicated, or folded and sutured, along its entire length to reinforce it. Alternatively, the aneurysm may be wrapped in mesh or graft material, which serves to both reduce the size of the aneurysm and provide additional support to the weakened vessel wall.