Leg Bypass with Vein or Prosthetic Graft
What is leg bypass surgery?
Arteries are blood vessels that supply oxygenated blood to all the parts of your body. Normally, the inner walls of the arteries have a smooth surface, to facilitate the easy flow of blood. When arteries become narrow, hard and stiff from a condition called atherosclerosis, it can cause blockages and reduce the flow of blood. Atherosclerosis involves the deposition of sticky plaque made up of calcium, cholesterol or fibrous tissue along the inside walls of your arteries. This plaque buildup eventually results in decreased oxygen supply to your organs and muscles. Atherosclerosis in blood vessels that supply blood to the limbs and other organs of our body is called peripheral artery disease (PAD).
PAD can be successfully treated through a bypass surgery. Leg bypass surgery is a procedure that involves treating your narrowed arteries by rerouting the flow of blood through a section of healthy vein or a prosthetic graft and bypassing the blocked section of the artery.
What can you expect before leg bypass surgery?
Before leg bypass surgery, your physician reviews your medical history and performs a thorough physical examination. Your doctor may order a blood test to determine cholesterol levels and imaging tests such as duplex ultrasound (uses sound waves to test the movement of blood in the vessels), magnetic resonance angiography (uses magnetic fields to image blood vessels) or computerized tomographic angiography (uses X-rays to image heart and blood vessels) to determine the location of the blockage and the best location for the attachment of the graft.
You will be instructed to limit or stop medications that can cause complications and not to eat or drink anything within 8 hours of your procedure.
What happens during leg bypass surgery?
During leg bypass surgery, you will receive general or spinal anesthesia so you do not feel any pain. Your surgeon prepares a graft by removing a healthy vein, usually the greater saphenous vein (that runs from the groin to the foot) from your own body, or by using a prosthetic graft (if no suitable vein is available ). An incision is made to expose the artery that is blocked and your pulse is checked to ensure that the bypass will receive sufficient blood flow. Clamps are placed at either end of the blocked section of the artery. An opening is made below the blockage in the artery. One end of the graft is sutured to the opening with permanent stitches. The graft is then routed to the region below the blockage. An opening is made at this region, and the graft is sutured to the opening. Clamps are then removed to allow the blood to flow freely.
Your doctor then ensures that the graft alignment is correct with no leakage, blood is flowing properly and the graft is functioning well. Your surgeon then closes the incisions with stitches.
What can you expect after leg bypass surgery?
After surgery, you will have to stay for 1-10 days in the hospital, during which time you will be closely monitored.
You may resume your physical activities on your doctor’s advice and will be asked to make appointments with your doctor for follow-up visits.
You should contact your physician immediately if you experience the following:
- cold painful arm or leg
- redness, discharge or swelling at your incision site
Are there any complications of leg bypass surgery?
Like all surgeries, leg bypass may be associated with complications such as, but not limited to:
- Swelling at the incision site
- Blockage of the bypass
- Loss of limb
- Heart attack
- Swelling of the limb (this usually occurs)
What do you need to do to stay healthy after the surgery?
Leg bypass surgery does not stop the recurrence of plaque deposition. Hence, you should adopt a healthy lifestyle to protect the success of the bypass surgery by doing the following:
- Controlling the levels of cholesterol and fat in your diet
- Quitting smoking
- Maintaining a healthy body weight
- Exercising regularly
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