02LW0DJ
Occlusion Thoracic Aorta, Descending to Temporary with Intraluminal Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 2 Heart and Great Vessels |
| Operation | L Occlusion |
| Body Part | W Thoracic Aorta, Descending |
| Approach | 0 Open |
| Device | D Intraluminal Device |
| Qualifier | J Temporary |
Operation Definition
Completely closing an orifice or the lumen of a tubular body part
Procedure Overview
Occlusion procedures on the heart and great vessels close off a vessel, chamber opening, or shunt so that blood can no longer pass through it. Surgeons use this approach to seal off a structure that is causing harm rather than to serve a useful purpose, such as an aneurysm, a patent foramen ovale, an atrial appendage prone to clot formation, or an abnormal connection between chambers. The closure can be done with a clip, plug, coil, suture, or occluder device delivered either through open surgery or a catheter threaded from a vessel in the leg or arm.
Patients encounter this family of procedures most often for stroke-prevention strategies, such as left atrial appendage closure in people with atrial fibrillation who cannot tolerate long-term blood thinners, or for closing a hole between heart chambers that never sealed after birth. The goal is always the same: eliminate flow through a specific pathway while leaving the surrounding anatomy otherwise intact.
Anatomy & Axis Detail
Thoracic Aorta, Descending
The descending thoracic aorta supplies the intercostal and bronchial branches and continues to the abdominal aorta at the diaphragm, and its occlusion is a high-stakes intervention generally reserved for controlling hemorrhage from traumatic aortic injury, managing complex dissection, or as a deliberate step in specific staged repairs, since complete closure interrupts perfusion to the distal aorta and its branches including the spinal arteries that can be critical for spinal cord viability. This may be performed with an endovascular balloon for temporary control, as in resuscitative endovascular balloon occlusion of the aorta, or with a more permanent surgical or device-based closure. Documentation should distinguish temporary occlusion for hemorrhage control from permanent occlusion intended as definitive treatment, since the clinical urgency and technique differ substantially.
Approach: Open
Open approach means the surgeon cuts through skin, mucous membrane, or other tissue layers to physically expose the target site to view before performing the procedure. It gives direct visualization and hands-on access, distinguishing it from Percutaneous approaches where instruments pass through a small puncture without exposing the site. Open is typical for procedures needing wide access, such as most laparotomies.
Device: Intraluminal Device
Intraluminal Device denotes a single device, such as a stent or occlusion device, positioned within the lumen of a tubular body part like a vessel, duct, or airway to maintain patency or occlude flow. It carries no drug coating or radioactivity, distinguishing it from the drug-eluting, radioactive, and bioactive intraluminal device values, and from Extraluminal Device, which sits outside rather than inside the lumen.
Qualifier: Temporary
This qualifier designates that a device, procedure, or structure created is intended for short-term rather than permanent use - for example a temporary tracheostomy, temporary pacemaker lead, or temporary vascular access. It distinguishes time-limited interventions, expected to be reversed or removed, from otherwise identical procedures performed with permanent intent.
Coding & Documentation
Coders assign Occlusion when the operative note describes a structure being completely closed off, not narrowed or partially blocked, which would instead point to Restriction. The documentation needs to specify the device used (occluder, clip, coil) and the approach, since percutaneous catheter-based closures carry a different device and approach value than an open surgical ligation of a vessel. A frequent error is confusing Occlusion with Excision or Destruction when a structure like an atrial appendage is removed or ablated rather than sealed shut - if tissue is taken out, Excision applies instead. Another common mix-up is failing to distinguish a diagnostic occlusion test from a therapeutic one; only the therapeutic closure is coded here.