A peripheral vascular bypass, also called a lower extremity bypass, is the surgical rerouting of blood flow around an obstructed artery that supplies blood to the legs and feet. This surgery is performed when the buildup of fatty deposits (plaque) in an artery has blocked the normal flow of blood that carries oxygen and nutrients to the lower extremities. Bypass surgery reroutes blood from above the obstructed portion of an artery to another vessel below the obstruction.

A bypass surgery is named for the artery that will be bypassed and the arteries that will receive the rerouted blood.

The three common peripheral vascular bypass surgeries are :-

  • Aortobifemoral bypass surgery, which reroutes blood from the abdominal aorta to the two femoral arteries in the groin.
  • Femoropopliteal bypass (fem-pop bypass) surgery, which reroutes blood from the femoral artery to the popliteal arteries above or below the knee.
  • Femorotibial bypass surgery, which reroutes blood between the femoral artery and the tibial artery.

What is surgical bypass? 

Surgical bypass treats your narrowed arteries by creating a bypass around a section of the artery that is blocked. During a bypass, your vascular surgeon creates a new pathway for blood flow using a graft. A graft is a portion of one of your veins or a man-made synthetic tube that your surgeon connects above and below a blockage to allow blood to pass around it.

You may be familiar with bypass surgery on heart arteries, but vascular surgeons also use bypasses to treat peripheral arterial disease (PAD). Surgeons use bypasses most commonly to treat leg artery disease, which is hardening of the arteries in the leg. Surgeons also use bypass to treat arm artery disease.

What can I Expect?

  • Prior to your procedure, tests may be scheduled such as blood work, electrocardiogram (ECG), and chest x-ray. These may be done at a separate appointment, or the day of the procedure
  • Your physician will order tests to locate the blockage and choose the best places to connect the graft.
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During bypass surgery of any artery : –

  • You will receive medicine (anesthesia) to make you unable to feel pain. The kind of anesthesia you receive will depend on what artery is being treated.
  • Your surgeon will make an incision (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 the blocked part of your artery. It may be made out of another blood vessel taken from your body during the same surgery. It may also be made of man-made material.
  • After the graft is sewn in place, your surgeon will make sure the blood flow to your lower leg is good. Then your incision will be closed. Your surgeon may do an x-ray called an arteriogram to check your blood flow.
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How do I prepare for bypass surgery?

Rest, eat well, quit smoking and walk or do the exercise allowed by your doctor. During your pre-operative visit, you will be instructed on special breathing exercises to help in your recovery. You will also be asked if you routinely take a blood thinner, such as an aspirin product or coumadin.

Several routine tests are done before surgery: EKG, echocardiogram, chest X-ray and blood tests. Make a list of any questions you have, and be sure to ask your doctor before surgery. Prior to your surgery, you will receive specific instructions about the food you can have. You will usually not be allowed to eat or drink after midnight the night before surgery. You may be instructed to shower with special soap.

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