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Peripheral artery bypass - leg

Definition

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.

See also:

• Angioplasty and stent replacement - peripheral arteries
• Peripheral artery disease

Alternative Names

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

Description

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 -- from your armpit

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.

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. 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 an incision in the lower part of your belly to do your surgery.

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 you. 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.

Risks

Risks for any anesthesia are:

• Allergic reactions to medicines
• Breathing problems

Risks for any surgery are:

• Blood clots in the legs that may travel to the lungs
• Breathing problems
• Heart attack or stroke
• Infection, including in the lungs, urinary tract, and belly

Risks for this surgery are:

• Damage to nearby organs in the body
• Infection in the incision
• The incision opens up
• You need to have a second bypass surgery or a leg amputation
• There is damage to a nerve that causes pain or numbness in your leg
• Sexual problems caused by damage to a nerve during aortofemoral or aortoiliac bypass surgery

Review Date: 2/9/2009
Reviewed By: Larry A. Weinrauch MD, Assistant Professor of Medicine, Harvard Medical School, Cardiovascular Disease and Clinical Outcomes Research, Watertown, MA.. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.