Why is this procedure done?
The iliac and femoral arteries are large blood vessels. They supply blood and oxygen from the heart to the legs. Sometimes, these arteries become narrow or blocked. If this happens, you will not get good blood flow to your legs. The block is caused by a buildup of a sticky material called plaque. The plaque can harden and make the blood vessel narrow. This may cause pain and other problems in your legs. Your legs may also feel cold or change colors. You may have wounds on your legs that will not heal. ‚
Aortoiliac and aortofemoral bypass graft surgery may be needed. This is done to treat and repair the blocked arteries. In a bypass, artificial tubes, or grafts, are placed near the part of the blood vessel that is blocked or narrow. The graft makes a path so that the blood can move around the blocked vessel. ‚
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What will the results be?
- Improved blood flow to your legs
- Relieve leg pain caused by a narrowed artery
- Prevent the need for leg removal
- Better wound healing or no wounds
- Improved movement and activity
What happens before the procedure?
- Your doctor will take your history. Talk to the doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- If you are pregnant or think you may be pregnant
- If you smoke. Your doctor will talk with you about quitting smoking.
- When you need to stop eating or drinking before your procedure
- When you should stop taking certain drugs before the procedure
- What drugs you should take with sips of water the day of your surgery
- Your doctor will do an exam and may order:
- Lab tests
- X-rays
- Ultrasound
- Angiogram
- Electrocardiogram (ECG)
- You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.
What happens during the procedure?
- Once you are in the operating room, the staff will put an I.V. in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery. Small stickers will be placed on your chest so the doctor can see your heart rate and rhythm. Staff will watch you closely during the procedure.
- You will be asleep for this surgery. While asleep, your doctor will make small cuts in your leg. Your doctor will take a healthy vein out of your leg. Your doctor will use this vein to bypass the artery that is blocked or narrowed.
- The doctor will make a long cut on your belly to open the abdominal cavity and will locate the blocked artery. The doctor will place clamps at the ends of the diseased section and take it out.
- The healthy vein will be stitched in its place. One end will be joined to the aorta and the other will be joined to the femoral or iliac arteries. Your doctor will allow blood to pass in the graft. Your doctor will check for leaks and repair them.
- Your doctor will let the blood pass through the graft to your legs.
- Your doctor will make sure you have good blood flow and that the graft is in place.
- When the graft is in place, your doctor will close your cut with stitches or staples and cover it with clean bandages.
- The procedure most often takes 2 to 4 hours.
What happens after the procedure?
- You will go to the Recovery Room or an Intensive Care Unit (ICU) after surgery.
- The staff will watch you closely. You may have machines and tubes connected to you including a heart monitor.
- The staff will place an ice pack wrapped in a towel over your leg. This will help ease pain and swelling.
- Based on what kind of bypass you had, you may have to spend 1 or 2 days in bed.
- Within a day or two, you will get out of bed to a chair. The staff will help you begin to walk around. Doing coughing and deep breathing exercises will help keep your lungs clear and prevent pneumonia. You will get drugs to help with your pain.
- When you are able to be out of bed and sit in a chair, keep your legs raised on a stool.
- You may wear a boot or special stockings to help prevent blood clots.
- You will need to stay in the hospital for 4 to 7 days.
What drugs may be needed?
The doctor may order drugs to: ‚
- Help with pain
- Prevent infection
- Soften stools
- Prevent blood clots
What problems could happen?
- Infection
- Bleeding
- Heart attack or stroke
- Injury to nearby organs
- Bowel blockage
- Blood clots
- Graft rejection
- Lesser movements of the leg
- Loss of leg
- Poor wound healing
- Problems with sex
When do I need to call the doctor?
Activate the emergency medical system right away if you have signs of a heart attack or stroke. Call 911 in the United States or Canada. The sooner treatment begins, the better your chances for recovery. Call for emergency help right away if you have: ‚
- Signs of heart attack:
- Chest pain
- Trouble breathing
- Fast heartbeat
- Feeling dizzy
- Signs of stroke:
- Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden severe headache with no known cause
Call your doctor if you have: ‚
- Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, cough, more sputum or change in color of sputum, pain with passing urine, or pain.
- Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
- Very bad belly pain or pain in your legs
- Not able to pass gas or you have a very upset stomach
- Loss of feeling in one or both legs or leg becomes cold
- Fluid is leaking from the cut site
- Coughing up blood
- Pain that does not go away with drugs
- More swelling in the legs or feet
Where can I learn more?
Circulation Foundation ‚
http://www.circulationfoundation.org.uk/help-advice/peripheral-arterial-disease/femoropopliteal-femorodistal-bypass/ ‚
Society for Vascular Surgery ‚
http://www.vascularweb.org/vascularhealth/Pages/surgical-bypass.aspx ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚