The goal of lower limb or extremity bypass surgery is to enhance blood flow to the thigh, calf, or foot. This procedure may be required to improve walking, alleviate pain, or heal ulcers or other lesions due to poor blood circulation in the lower extremities.
2 categories of lower extremity bypass
Patients who have this bypass surgery usually fall into one of two categories:
The first category
- Patients who have intermittent claudication or pain, commonly in the calf muscle, after walking a specific distance.
- This discomfort comes as a result of a blockage or narrowing of the arteries, which restricts blood supply to the muscles.
- These patients are unlikely to lose their limb without surgery, but with a successful bypass, the blood supply to the working muscles is enhanced, and patients are often able to walk much further.
The second category
- Patients undergoing this procedure have substantially reduced blood flow to their legs, resulting in ulcers or tiny patches of gangrene.
- Chronic pain, mainly in the foot, is a common symptom.
- In this case, a successful bypass could be the difference between saving or losing a limb.
How is lower extremity bypass performed?
Typically, the surgery is carried out under general or epidural anesthesia. The procedure is intended to enable blood flow that bypasses the occlusion via a vein or a plastic graft.
- Before surgery, the blood flow will be evaluated using Duplex scans and a dye test to determine the ideal location for the graft to begin and stop.
- The graft will usually go from the groin to around the knee, although it may run just above the groin or down to the calf or foot. The surgeon should go through all the specifics of your procedure with you.
- You may undergo a scan to see whether the vein in your leg is suitable for use as a graft. However, if it has previously been removed, is too small, or is not functioning properly, a plastic graft may be required.
- Cuts will be made in the leg above the groin and along the inside of the knee. The graft (autogenous or synthetic) is attached. At the end of the procedure, the incisions will be closed with stitches or clips.
On day two, you should be sitting up and after about four days, you should be walking to the restroom. Most people expect to return home in about seven days.
What are the possible risks of lower extremity bypass?
As with every procedure, some risks will be involved.
Patients with advanced peripheral artery disease have a high frequency of significant heart disease, so a thorough evaluation for cardiac problems and a careful review of medical therapies are required before surgery.
Lower extremity bypass surgery has common risks, which may include:
- Side effects of anesthesia
- Graft failure
- Heart attacks
- Blood clots
- Discomfort in the leg as incisions heal
- Wound healing problems
- A small number of individuals experience severe scarring at the graft, which can result in substantial narrowing again
The side effects are rare; however, the symptoms you had preoperatively should be improved immediately.
Patients may need regular six months checkups to identify any complications. Patients will need to be on blood thinners forever and should never smoke again. Both measures are important to prevent the graft from blocking off.
What is the outcome of lower extremity bypass?
Overall, 90 to 95 percent of bypass surgeries are initially successful.
The material used for the bypass graft itself, as well as the quality of the arteries in the lower leg to which the graft is joined, are most directly associated with the procedure's short and long-term success.
- The best results are obtained by doing these grafts on a patient's vein, most commonly the saphenous vein from the inside of the leg.
- When a suitable saphenous vein of adequate length is not available, surgeons may utilize other veins from the arm or leg or an artificial (prosthetic) graft. However, these alternatives may have a lower success rate.
- As a result, whether a good vein is likely to be available to execute the bypass is a significant consideration while selecting this treatment for a patient.
- After surgery, smoking cessation and ongoing medical care, including aspirin and cholesterol-lowering medications, are crucial.
- Patients who have had successful bypass surgery should expect pain alleviation, improved healing of foot sores, increased walking capacity, and long-term freedom from amputation if the graft continues to work.
Lower extremity bypass surgery is the most effective and long-lasting therapy now available for many patients with severe peripheral arterial disease.
- Your Guide to Hepatitis C Medications
- CDC Raises Alarm About Meningitis Threat to Patients Visiting Mexican Surgical Clinics
- What Is Irritable Bowel Syndrome?
- New Approach to Transplants Could Boost Supply of Donor Hearts
- Experts Warn of Heart Dangers From Smoke of Canadian Wildfires
- More Health News »
Health Solutions From Our Sponsors
The MetroHealth System. Lower Extremity Bypass. https://www.metrohealth.org/vascular-surgery/treatments/lower-extremity-bypass
The Ottawa Hospital Foundation. What Is Leg Bypass Surgery? https://ohfoundation.ca/leg-bypass-surgery/
The Cochrane Collaboration. Bypass surgery for chronic lower limb ischemia. https://www.cochrane.org/CD002000/PVD_bypass-surgery-chronic-lower-limb-ischaemia
Top What Is Lower Extremity Bypass Related Articles
Are Gastric Bypasses Reversible?Gastric bypass or Roux-en-Y gastric bypass operations are reversible, but the reversal procedure is risky. The attempt to reverse the bypass to normal anatomy can cause rare but serious complications. The parts of the stomach and small intestine can be put together again but their function will never be quite the same.
Can You Live a Normal Life After Gastric Bypass?Gastric bypass surgery, also known as a Roux-en-Y, is one kind of weight-loss surgery. You can live a normal live after gastric bypass but you have to change your diet, exercise and lifestyle habits.
Can You Reverse Plaque Buildup in Your Arteries?There are two types of cholesterol in your body. Doctors cannot remove plaque completely from your arteries, but treatments can reduce the size of a blockage.
Coronary Artery Bypass Graft (CABG)Coronary artery bypass graft (CABG) surgery is performed to relieve angina in individuals who have failed medical therapy and are not good candidates for angioplasty (PTCA). CABG surgery is ideal for individuals with multiple narrowings in multiple coronary artery branches. Mortality and complications increase with:
- older age,
- poor heart muscle function,
- disease obstructing the left main coronary artery,
- chronic kidney failure,
- and chronic lung disease.
DVT SlideshowDeep vein thrombosis (DVT) is a dangerous and sometimes fatal blood clot that occurs deep within the lower leg or thigh. Understand the symptoms, treatment and prevention of deep vein thrombosis (DVT).
Gastric Bypass SurgeryGastric bypass surgery is a procedure that creates a small stomach pouch to restrict food intake and constructs bypasses of the duodenum and parts of the small intestine to decrease one's ability to absorb nutrients from food. There are two types of gastric bypass operations: Roux-en-Y and extensive gastric bypass. Patients who undergo gastric bypass surgery will need to take nutrition supplements due to limited absorption of certain vitamins and minerals.
How Do I Get Rid of Spider Veins on My Legs?Learn what medical treatments can reduce the appearance of spider veins and help you manage this condition.
How Is Coronary Artery Bypass Graft Performed?Coronary artery bypass grafting (CABG) is a surgery performed in patients with coronary artery disease (CAD). Coronary artery bypass grafting (CABG) is a surgery that helps create adequate blood flow to the heart by using healthy blood vessels harvested from some other sites (e.g., leg, arm or chest) to bypass the flow of blood from the site of the blockage. Complications include bleeding, irregular heartbeat, heart attack, stroke, kidney failure, cardiac tamponade, infections, and injury to blood vessels.
Peripheral Vascular DiseasePeripheral vascular disease (PVD) refers to diseases of the blood vessels (arteries and veins) located outside the heart and brain. While there are many causes of peripheral vascular disease, doctors commonly use the term peripheral vascular disease to refer to peripheral artery disease (peripheral arterial disease, PAD), a condition that develops when the arteries that supply blood to the internal organs, arms, and legs become completely or partially blocked as a result of atherosclerosis. Peripheral artery disease symptoms include intermittent leg pain while walking, leg pain at rest, numbness in the legs or feet, and poor wound healing in the legs or feet. Treatment for peripheral artery disease include lifestyle measures, medication, angioplasty, and surgery.
Varicose Veins SlideshowLearn the causes of spider veins and varicose veins and how to prevent them. Explore which treatments get rid of spider and varicose veins and view before-and-after vein treatment images.
Vascular DiseaseVascular disease includes any condition that affects your circulatory system. Vascular disease ranges from diseases of your arteries, veins and lymph vessels to blood disorders that affect circulation.
Vascular Malformations on Foot PictureVascular malformations occur when capillaries, veins, arteries, or lymphatic vessels don’t develop properly. They are always present at birth although they may not be apparent until adolescence or adulthood. VMs range in size from small dots to large disfigurations, like this one on a patient’s foot. They can be sensitive to touch and very painful.
What Is a Tunneled Central Vascular Access Device?A tunneled central vascular access device is used when access to a large vein is needed for a long period of time to provide intravenous nutrition or medications.