Peripheral artery bypass is a surgical treatment for peripheral artery disease (PAD), a condition in which an artery becomes blocked by a buildup of hard, fatty material known as plaque (atherosclerosis). Peripheral arteries, such as the femoral and popliteal arteries in the legs, are often involved in the process of atherosclerosis. The surgical procedure involves using a graft (artificial plastic tube or vein) to bypass the blacked area of the artery.
Most often, peripheral artery bypass is performed from the groin to the lower leg (e.g. femoral-popliteal bypass surgery), but may also done to treat blockages in the axillary artery in the armpit, in the iliac artery in the hip or in the chest.
Most cases of a blocked peripheral artery that occur in a leg present with aches, heaviness or pain in the thigh, calf or buttocks that becomes worse while walking. Symptoms that only appear when walking and do not interfere with everyday activities may be treated with medication or other therapies. The reasons for peripheral artery bypass surgery include:
- Symptoms interfere with daily tasks
- Symptoms do not respond to other treatments
- Infection or gangrene
- Skin ulcers or wounds on the leg that do not heal
- Pain that occurs at rest or lying down
A thorough examination including tests of the heart and lungs helps determine if you are healthy enough to undergo anesthesia. A complete medical history notes the use of prescription and over-the-counter drugs as well as herbs and supplements, if the person has an illness, a pacemaker, is pregnant, has bleeding disorders or has allergies to any medications.
Prior to surgery, it is important to stop smoking. It may also be necessary to stop taking medications that impair the ability of the blood to clot such as aspirin, ibuprofen and naprosyn (Aleve). The patient will be instructed to fast for eight hours before the surgery.
Peripheral artery bypass surgery may be done using either a general, spinal or local anesthetic with a mild sedative to relax the patient. Depending on the procedure, a hospital stay of four to seven days may be required. In most cases, an overnight stay in the intensive care unit (ICU) may be required following surgery. After one to two days, the patient slowly begins to resume walking with aid of physical therapy. A lump or knot may appear at the surgical site, but should disappear in a few weeks. Full recover may take six to eight weeks.
Once at home, strenuous activities need to be avoided until the doctor advises it is okay to resume work and normal tasks. In addition, medications may be prescribed to keep blood from clotting in the arteries.
Peripheral artery bypass helps increase blood flow to the affected limb but does not cure PAD. Arteries may become clogged again unless factors that cause the disease are controlled, such as quitting smoking, eating a healthy diet low in fat, salt and cholesterol, and exercising regularly.