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Femoral-tibial bypass surgery (also known as
infra-popliteal reconstruction) is used to bypass diseased blood vessels in the
lower leg or foot.
To bypass the narrowed or blocked blood vessel, blood is
redirected through a healthy blood vessel that has been transplanted or through
a man-made graft material. This vessel or graft is sewn above and below the
diseased artery so that blood flows through the new vessel or graft. Before
surgery, the doctor determines what type of material is best suited to bypass
the blood vessel.
Whenever possible, the surgeon will choose to
use an existing piece of vein taken from either leg. Man-made graft materials
(such as polytetrafluoroethylene [PTFE] or Dacron) are more likely to become
narrowed again. But they may still be effective and are used when a vein is not
The section of vein or man-made blood vessel is sewn
onto the small vessels of the lower leg or foot so that blood can travel
through the new graft vessel and around the diseased area.
or an injection in the spine (epidural) is used for this surgery. General
anesthesia will cause you to sleep through the procedure. An epidural prevents
pain in the lower part of the body.
You may need
to stay in the hospital for 3 to 5 days.
You will have some pain from the cuts (incisions) the doctor made. The pain usually gets better after about 1 week. Your doctor will give you pain medicine. You can expect your leg to be swollen at first. This is a normal part of recovery and may last 2 or 3 months.
You will need to take it easy for 2 to 6 weeks at home. It may take 6 to 12 weeks to fully recover.
You will probably need to take at least 2 to 6 weeks off from work. It depends on the type of work you do and how you feel.
You will need to have regular checkups with your doctor to make sure the graft is working.
This surgery is used for people who
have narrowed or blocked tibial or peroneal arteries, which are near the
surface of the legs. Most of the time, people also have narrowed or blocked femoral and
popliteal arteries too. Usually, a person has severe symptoms
or the problem is limb-threatening before bypass surgery is considered.
Bypass surgery can restore blood flow and relieve intermittent claudication.footnote 1
All surgeries carry a certain amount of risk. These risks include:
Specific risks for this bypass surgery include:
Your doctor may recommend that you try an exercise program and medicine before he or she recommends that you have this surgery.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
Hirsch AT, et al. (2006). ACC/AHA 2005 practice guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): A collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation, 113(11): e463–e654.
ByHealthwise StaffPrimary Medical ReviewerRakesh K. Pai, MD, FACC - Cardiology, ElectrophysiologySpecialist Medical ReviewerDavid A. Szalay, MD - Vascular Surgery
Current as ofFebruary 20, 2015
Current as of:
February 20, 2015
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology & David A. Szalay, MD - Vascular Surgery
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