An aortobifemoral bypass is a major surgery that has a success rate of about 80% and a mortality rate of about 2%-5%. The goal of the surgery is to redirect blood flow around a blocked artery and reduce symptoms for at least 10 years, provided precautions are taken.
What are the risks of an aortobifemoral bypass?
An aortobifemoral bypass is typically done under general anesthesia and takes about 2-3 hours. You may need to stay for a few days in the hospital after the surgery and take it easy for about 4-6 weeks after you get discharged.
Complications associated with the procedure mainly depend on your general health and whether you have any underlying health conditions, such as high blood pressure, diabetes, heart disease, lung disease, or kidney disease.
Risks associated with aortobifemoral bypass include:
- Infection
- Bleeding
- Anesthesia-related complications
- Graft failure or blockage
- Heart attack
- Stroke
- Nerve damage
- Kidney damage
- Respiratory failure
How is an aortobifemoral bypass done?
During an aortobifemoral bypass, a path is created to redirect blood flow between the aorta (major blood vessel carrying blood from the heart) and the two femoral arteries (blood vessels that carry blood from the blood vessels in the abdomen to the legs). The procedure is done when there is an obstruction to the flow of blood due to a narrowed or blocked segment of the artery.
The surgeon creates a bypass or a direct connection between the aorta and the femoral arteries to facilitate blood flow to the lower limbs. A synthetic graft shaped like an inverted “Y” is used. The stem of the Y emerges from the aorta in the abdomen and the two top parts of the Y are connected to the two femoral arteries beyond the site of obstruction or blockage.
Why is an aortobifemoral bypass done?
An aortobifemoral bypass is done when there is a blockage of blood vessels in the abdomen, groin, or pelvis. Reduced blood flow may cause symptoms such as pain, swelling, heaviness, or skin color changes in the legs as well as sexual problems.
Symptoms may be mild initially, causing problems only when walking, running, or standing and relieved with rest. Over time, symptoms may appear even at rest and may interfere with daily tasks.
Major indications of aortobifemoral bypass include the following:
- Atherosclerosis (hardening of arteries due to the buildup of fats, cholesterol and other substances in and on the artery wall) of the abdominal aorta or iliac arteries
- Severe claudication symptoms (such as pain and cramps that are not relieved by rest or causing severe impairment in daily tasks or changes in the skin over the legs)
- Impotence
- Nonhealing ulcers over the feet or legs
- Aortic aneurysms (ballooning of the aorta) involving the iliac arteries (blood vessels that provide blood to the legs, pelvis, and pelvic organs including the reproductive organs)
- Acute abdominal aortic occlusion (a rare life-threatening condition that occurs due to sudden blockage of the abdominal aorta due to a blood clot or embolus)
- Critical limb-threatening ischemia (a serious condition occurring in an advanced stage of peripheral artery disease, causing symptoms such as pain, ulcers, and gangrene)
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Bhimji S. Aortic Bifemoral (Aortobifemoral) Bypass. Medscape. https://emedicine.medscape.com/article/1830241-overview#a5
Berger JS, Davies MG. Overview of lower extremity peripheral artery disease. UpToDate. https://www.uptodate.com/contents/overview-of-lower-extremity-peripheral-artery-disease
Ibrahim D. Aortobifemoral bypass graft. Case study, Radiopaedia.org. (accessed on 24 May 2022) https://doi.org/10.53347/rID-31497
Dellehunt RE, Manna B. Aortofemoral Bypass. [Updated 2022 Jan 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542328/
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