Clinical Context
A patient in their 60s presents to the hospital emergency department with acute onset unilateral leg swelling, pain, and reduced distal perfusion. Duplex ultrasound and CT venography confirm a large iliofemoral deep vein thrombosis with significant clot burden and clinical threat to limb viability. Endovascular thrombectomy/embolectomy is planned by an interventional radiologist or vascular surgeon. The patient is transported to an interventional suite or hybrid operating room. Under conscious sedation or general anesthesia, vascular access is obtained (commonly via the popliteal, femoral, or internal jugular vein/artery depending on clot location). A specialized thrombectomy/embolectomy catheter (C1757) is advanced to the thrombus under fluoroscopic guidance. Mechanical thrombectomy devices and adjunctive pharmacologic thrombolysis may be used. Completion venography assesses clot removal and vessel patency; adjunctive angioplasty or stent placement may follow if residual stenosis is present. Post-procedure monitoring occurs in a recovery area or intensive care unit depending on hemodynamic stability and thrombolytic therapy. Discharge planning includes anticoagulation therapy and outpatient follow-up with vascular medicine or surgery.
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|
37184 | Endovascular mechanical thrombectomy, percutaneous, arterial, intracranial or extracranial, single vessel, including radiological supervision and interpretation, when performed | May be used for arterial mechanical thrombectomy procedures when arterial embolus removal precedes or accompanies catheter thrombectomy. |
| 37211 | Transcatheter therapy, percutaneous, non-coronary, any method, with thrombolysis, any site, including catheter placement, infusion monitoring, and subsequent removal when performed | Used when catheter-directed thrombolysis is administered in conjunction with thrombectomy for venous or arterial clots.
| 36011 | Introduction of needle or catheter into femoral vein for diagnostic or therapeutic injection, not otherwise specified | Reflects basic venous access coding when separate access coding is required in documentation.
| 93571 | Comprehensive local endovascular catheterization, including removal of embolus or thrombus, peripheral, therapeutic, percutaneous | Used in some settings for peripheral vascular thrombectomy procedures as an alternative or adjunct to device-specific codes.
| 36901 | Endovascular thrombectomy, peripheral vessel, includes mechanical thrombectomy, when performed | Represents peripheral thrombectomy procedures often billed alongside device supply codes like C1757.