Peripheral artery bypass - leg

Definition

Peripheral artery bypass is surgery to reroute the blood supply around a blocked artery in one of your legs. Fatty deposits can build up inside the arteries and block them.

A graft is used to replace or bypass the blocked part of the artery. The graft may be a plastic tube, or it may be a blood vessel taken from your body (most often the opposite leg) during the same surgery.

Alternative Names

Aortobifemoral bypass; Femoropopliteal; Femoral popliteal; Aorta-bifemoral bypass; Axillo-bifemoral bypass; Ilio-bifemoral bypass; Femoral-femoral bypass; Distal leg bypass

Description

Peripheral artery bypass surgery can be done in one or more of the following blood vessels:

During bypass surgery of any artery:

If you are having bypass surgery to treat your aorta and iliac artery or your aorta and both femoral arteries (aortobifemoral):

If you are having bypass surgery to treat your lower leg (femoral popliteal):

Why the Procedure Is Performed

Symptoms of a blocked peripheral artery are pain, achiness, or heaviness in your leg that starts or gets worse when you walk.

You may not need bypass surgery if these problems happen only when you walk and then go away when you rest. You may not need this surgery if you can still do most of your everyday activities. Your doctor can try medicines and other treatments first.

Reasons for having arterial bypass surgery of the leg are:

Before having surgery, your doctor will do special tests to see the extent of the blockage.

Risks

Risks for any anesthesia and surgery are:

Risks for this surgery are:

Before the Procedure

You will have a physical exam and many medical tests.

Always tell your health care provider what medicines you are taking, even drugs, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

DO NOT drink anything after midnight the night before your surgery, including water.

On the day of your surgery:

After the Procedure

Right after surgery, you will go to the recovery room, where nurses will watch you closely. After that you will go either to the intensive care unit (ICU) or a regular hospital room.

When your doctor says it is ok, you will be allowed to get out of bed. You will slowly increase how far you can walk. When you are sitting in a chair, keep your legs raised on a stool or another chair.

Your pulses will be checked regularly after your surgery. The strength of your pulse will show how well your new bypass graft is working. While you are in the hospital, tell your provider right away if the leg that had surgery feels cool, looks pale or pink, feels numb, or if you have any other new symptoms.

You will receive pain medicine if you need it.

Outlook (Prognosis)

Bypass surgery improves blood flow in the arteries for most people. You may not have symptoms anymore, even when you walk. If you still have symptoms, you should be able to walk much farther before they start.

If you have blockages in many arteries, your symptoms may not improve as much.

References

Creager MA and Libby P. Peripheral arterial diseases. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 58.

Kinlay S, Bhatt DL. Treatment of noncoronary obstructive vascular disease.In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 60.


Review Date: 2/27/2015
Reviewed By: Deepak Sudheendra, MD, RPVI Assistant Professor of Interventional Radiology & Surgery at the University of Pennsylvania, with an expertise in Vascular Interventional Radiology & Surgical Critical Care, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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