CPT® Code 37220

Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty

The procedure described by CPT® Code 37220 involves the revascularization of an occluded or narrowed iliac artery, which is a major blood vessel in the pelvis that supplies blood to the lower limbs. This revascularization can be performed using either an open surgical approach or a percutaneous (minimally invasive) technique, with the initial vessel being treated on a unilateral basis, meaning only one side of the body is addressed during the procedure. The primary method employed in this procedure is transluminal angioplasty, which involves the use of a balloon catheter to dilate the affected artery. The physician may also utilize stent placement to ensure the artery remains open after the procedure. In the open approach, the physician prepares the skin over the access artery, makes an incision, and exposes the artery for direct access. In contrast, the percutaneous approach involves puncturing the skin over the access artery, typically one of the femoral arteries, and inserting a sheath through which instruments can be introduced. Throughout the procedure, radiological supervision is often employed to guide the physician in navigating the guidewire and catheters to the site of the occlusion. The angioplasty process includes inflating a balloon to compress plaque against the arterial wall, which may be repeated multiple times to achieve optimal results. Following the angioplasty, a completion angiography is performed to confirm that the artery is patent, and if necessary, a stent is deployed to maintain the artery's openness. The procedure concludes with the removal of all catheters and appropriate closure of the access site, whether through direct repair in the open approach or through pressure application in the percutaneous method.