CPT® Code 37184

Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial vessel

The CPT® Code 37184 refers to the procedure known as primary percutaneous transluminal mechanical thrombectomy, which is specifically performed on noncoronary, non-intracranial arteries or arterial bypass grafts. This procedure is essential for the removal of blood clots that obstruct blood flow in these vascular structures. During the thrombectomy, a physician utilizes an arterial catheter along with a mechanical device designed to disrupt and remove the thrombus, or blood clot, from the affected area. The mechanical devices employed can vary, including those that fragment the clot through mechanical action, such as rotating wires or brushes, and those that utilize hydrodynamic forces to break up the clot while simultaneously aspirating the debris. The procedure is guided by fluoroscopy, which provides real-time imaging to assist the physician in navigating the catheter and devices to the site of the thrombus. The process begins with the preparation of the skin over the access artery, followed by puncturing the artery and placing a sheath. A guiding catheter is then introduced, and a microcatheter is advanced through the thrombus using a microguidewire. Depending on the type of mechanical device used, the physician may activate the device to fragment the clot or deploy a retriever device to capture and remove the thrombus. The use of a thrombolytic agent may also be incorporated during the procedure to enhance clot dissolution. This comprehensive approach ensures effective removal of the clot, restoring normal blood flow in the affected artery or graft.