CPT® Code 37187

Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance

Percutaneous transluminal mechanical thrombectomy is a minimally invasive procedure performed on veins to remove blood clots, known as thrombi. This procedure utilizes a catheter and specialized mechanical devices designed to either break up the thrombus, remove it, or capture it for extraction. The process is guided by fluoroscopy, which provides real-time imaging to assist the physician in navigating the vascular system and accurately targeting the thrombus. During the procedure, intraprocedural pharmacological thrombolytic injections may be administered to enhance the dissolution of the clot. The thrombectomy technique can vary based on the type of mechanical device employed, which may include rotating wires, brushes, or retriever devices such as snares or baskets. The physician begins by preparing the skin over the targeted blood vessel, puncturing it, and placing a sheath to facilitate access. A guiding catheter is then introduced under fluoroscopic guidance, followed by the advancement of a microcatheter through the thrombus. The mechanical thrombectomy device is subsequently deployed to fragment or remove the clot, with the possibility of multiple passes being necessary to achieve complete removal. This procedure is critical for restoring blood flow in cases of venous thrombosis and is coded as CPT® 37187 for the initial treatment session.