CPT® Code 37185

Add-On Code

Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); second and all subsequent vessel(s) within the same vascular family (List separately in addition to code for primary mechanical thrombectomy procedure)

The CPT® Code 37185 refers to a specific medical procedure known as primary percutaneous transluminal mechanical thrombectomy, which is performed on noncoronary, non-intracranial arteries or arterial bypass grafts. This procedure is essential for treating occlusions caused by blood clots 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 procedure is guided by fluoroscopy, which provides real-time imaging to assist the physician in navigating the vascular system and ensuring accurate placement of the devices used. The mechanical thrombectomy can involve various techniques, including the use of rotating wires or brushes that fragment the clot, or hydrodynamic devices that deliver a rapid stream of fluid to break up the thrombus, followed by aspiration to remove the debris. Additionally, retriever devices such as microsnares and snare baskets may be employed to capture and extract the clot. The approach taken can vary based on the specific device utilized and the location of the thrombus within the vascular system. The procedure is typically initiated by preparing the skin over the access artery, puncturing the artery, and placing a sheath. A guiding catheter is then introduced under fluoroscopic guidance, followed by the advancement of a microcatheter over a microguidewire through the thrombus. Once the guidewire is removed, the mechanical thrombectomy device is advanced to the site of the clot. The procedure may require multiple passes of the mechanical device to effectively break up and remove the clot. In some cases, a thrombolytic agent may also be injected during the procedure to enhance clot dissolution. After the thrombectomy is completed, all devices used, including the mechanical device, microcatheter, and guiding catheter, are removed from the patient.