Ask Dr. Z

"Repaired popliteal artery to popliteal vein acquired fistula. Subcutaneous flaps developed superiorly and inferiorly. Fascia entered. Lesser saphenous vein ligated. Dissection to incise the deep fascia. Careful dissection to isolate popliteal vein and popliteal arterires proximally. Level of fascia identified and distal extension of exposure between stress of gastrocnemius performed to expose distal vein and distal artery. Pop both ends of the artery were separate feeding into common aneurysmal dilatation between artery and vein. (CPT 35190.) There was no way to primarily repair fistula using simple closure. Using vertical superior incision aspect of vertical superior incision, the GSV harvested. 10 cm piece removed. Piece reversed and anastamosed end-to-end to popliteal artery proximally and end-to-end to pop artery distally. Next GSV anastomosed end-to-end to the popliteal vein distally." Is 35190 correct? What do we use for the A) popliteal artery interposition bypass graft, and B) popliteal vein interposition bypass graft using the greater saphenous vein?