Peripheral artery disease (PAD) is a condition in which the arteries that supply blood and oxygen to the lower extremities become narrowed and hardened. Typically, this condition is caused by the build up of plaque and fat on artery walls; which narrows the vessels that connect to the lower extremities. This narrowing of the arteries restricts blood from reaching the legs and feet. Blood clots can also form and completely block the artery. People with PAD may complain of symptoms such as pain while walking; pain at night; rest pain; sores on feet and legs that will not heal; and dead tissue/gangrene.
Peripheral artery disease is often initially treated with medication, exercise, smoking cessation, wound care, and in some cases angioplasty is performed. For many types of blockages, however, bypass surgery is the best option for treatment. A surgical bypass creates new pathways for oxygen-rich blood to flow into the lower extremities and bypass the blocked arteries.
Bypass Surgery
General or spinal anesthesia is administered to the patient during a surgical bypass. There are two locations where a surgical bypass may occur; the leg or the abdomen. A lower extremity bypass is often referred to as; leg bypass, fem-pop bypass, fem-tib bypass, or fem-distal bypass. An abdominal bypass is often referred to as; aortic bypass, aorto-iliac bypass, aorto-femoral bypass, fem-fem bypass, aorto-mesenteric bypass, or ax-fem bypass. The various types of bypasses depends on which blood vessel is being bypassed during the procedure.
During the procedure, an incision about 4-8 inches long is made at the groin or mid-line crease, and again at the end point. A natural or synthetic graft is used to create the detour around the blockage. The graft is sewn to the artery at both ends with fine stitches. This procedure may take any where from 1.5- 6 hours.
Recovery From Bypass Surgery
After a surgical bypass, most patients experience incision pain/ discomfort for several days. A few weeks after the surgery, patients will be able to return to work and independently complete activities of daily living.
Risks Of Bypass Surgery
As with any invasive procedure there are risks associated with bypass surgery. Risks include:
- Heart attack
- Infections
- Stroke
- Pneumonia
The risk of developing these complications depends on the overall health of the patient prior to surgery. Any concerns should be discussed with a doctor prior to undergoing surgery. Although bypass surgery improves blood supply to lower extremities, it does not cure underlying peripheral artery disease. Medication and healthy lifestyle changes are strongly recommended to reduce the risk of recurring vascular disease, and the need for additional vascular surgery in the future.
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