cpt code for vein patch angioplasty of brachial artery

A venogram can be performed to assess for stenotic lesions. If the graft is pulsatile without a thrill, a distal obstruction may be present. If the graft twisted in the tunnel, the anastomosis may need to be taken down and the vein retunneled. Revision may be necessary if a thrill is not readily palpable. The clamps are removed, with the distal arterial clamp removed last. If the graft has a pre-existing (i.e., manufactured) venous hood, the venous anastomosis should be performed ﬁrst to size the length of the graft appropriately. The vessels are clamped, and end-to-side anastomoses are performed to the target artery and vein with 6-0 Prolene suture.

A small hood is cut in each end of the graft, which is oriented according to the direction of ﬂow. Once the tunnel is completed, the patient is heparinized. A counter-incision may be required, depending on the anatomic location (Figure 90-22). The graft is tunneled, with care taken to keep the graft untwisted and to maintain a proper depth (approximately 4 mm).

Proximal and distal control of both vessels is obtained. Arterial inﬂow and venous outﬂow are isolated.

Cpt code for vein patch angioplasty of brachial artery