Peripheral artery bypass - leg - Overview
Aortobifemoral bypass; Femoropopliteal; Femoral popliteal; Aorta-bifemoral bypass; Axillo-bifemoral bypass; Ilio-bifemoral bypass; Femoral-femoral bypass; Distal leg bypass
Definition of Peripheral artery bypass - leg:
Peripheral artery bypass is surgery to reroute the blood supply around a blocked artery in one of your legs. Your peripheral arteries can become blocked with fatty material that builds up inside them. This is called atherosclerosis.
Peripheral artery bypass surgery can be done in one or more of these arteries to treat a blockage:
- Aorta -- the main artery that comes from your heart
- Iliac artery -- in your hip
- Femoral artery -- in your thigh
- Popliteal artery -- behind your knee
- Tibial and peroneal artery -- in your lower leg
- Axillary artery -- in your armpit
During bypass surgery of any artery:
- You will receive medicine (anesthesia) so that you do not feel pain. The kind of anesthesia you receive will depend on what artery is being treated.
- Your surgeon will make a cut over the blocked area of the artery. The surgeon will then move skin, muscle, and other tissue out of the way.
- Your surgeon will place clamps on the artery at each end of the blocked section. The surgeon will then use a graft to replace or bypass the blocked part of your artery. The graft may be a plastic tube, or it may be a blood vessel taken from your body (usually the opposite leg) during the same surgery.
- After the graft is sewn in place, your surgeon will make sure the blood flow to your lower leg is good. Then your cut will be closed. Your surgeon may do an x-ray called an arteriogram to make sure that the graft is working.
If you are having aortoiliac (to treat your aorta and iliac artery) or aortobifemoral (to treat your aorta and both femoral arteries) bypass surgery:
- You will probably have general anesthesia. This will make you unconscious and unable to feel pain. Or you may have epidural or spinal anesthesia. The doctor will inject your spine with medicine to make you numb from your waist down.
- Your surgeon will make a surgical cut in the middle of the abdoman to reach the aorta and iliac arteries.
If you are having femoral popliteal bypass surgery (to treat your lower leg):
- You may have general anesthesia. You will be unconscious and unable to feel pain. You may instead have an epidural or spinal anesthesia. The doctor will inject your spine with medicine to make you numb from your waist down. Some people have local anesthesia and a medicine to relax them. Local anesthesia numbs just the area being worked on.
- Your surgeon will make a cut in your leg between your groin and knee. It will be near the blockage in your artery.
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:
- Your symptoms keep you from doing your everyday tasks.
- Your symptoms do not get better with other treatment.
- You have skin ulcers (sores) or wounds on your leg that do not heal.
- You have an infection or gangrene in your leg.
- You have pain in your leg from your narrowed arteries even when you are resting or at night.
Before surgery is considered, the doctor will order special tests to show that you have a severe blockage in your blood vessels.
- Reviewed last on: 1/25/2011
- Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Creager MA and Libby P. Peripheral arterial disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Saunders; 2007:chap 57.
Eisenhauer AC, White CJ. Endovascular treatment of noncoronary obstructive vascular disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 59.
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