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by Scholten A
(Leg Artery Bypass Surgery; Femoral Popliteal Bypass;)

Definition

Femoropopliteal bypass is surgery to route blood around a blocked main leg artery. A graft is made from a vein or artificial tube. The graft makes a new path for the blood.

Femoropopliteal Bypass Graft
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Reasons for Procedure

Femoropopliteal bypass graft may be done to:

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from the anesthesia
  • Blood clots
  • Damage to other organs or structures
  • Infection
  • Heart attack

What to Expect

Prior to Procedure

The doctor may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Tests that will need to be done before surgery

Anesthesia

The doctor will give:

Description of the Procedure

An incision will be made in the leg. The doctor will take out a vein. The vein will be used to make the bypass graft. If the vein cannot be used, an artificial vein is used.

Next, an incision will be made in the groin. It will expose the femoral artery. This is the artery in the thigh. The doctor will make another incision at the back of the knee to expose another artery. This is called the popliteal artery.

The doctor will use clamps to block the flow of blood through these two arteries. One end of the new bypass vein will be stitched into the femoral artery. The other end will be stitched into the popliteal artery. The doctor will check the graft for leaks and repair any. The clamps will then be removed. This will allow blood to flow through the graft to the lower leg. The incisions will be stitched. A bandage will be placed over the site.

Sometimes a vein in the thigh is used as a graft while left in place. In this procedure, the valves inside the vein will be removed with a small scope and tool. The vein will then be attached to the arteries to form a graft.

How Long Will It Take?

1 to 3 hours

Will It Hurt?

There may be some pain for weeks or even months. Pain medicine will help.

Average Hospital Stay

7 to 10 days

Post-procedure Care

At the Hospital

During your stay, the hospital staff will take steps to lower your risk of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to lower your risk of infection such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions
At Home

It may take 6 weeks or longer to recover. The doctor may advise exercise, physical therapy, and lifestyle changes.

Call Your Doctor

Call your doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • A cold, pale, blue, tingly, or numb leg
  • Excess bleeding, redness, swelling, or any discharge from the incision site
  • Lasting nausea, vomiting, or problems passing stool (poop) or urine
  • Pain that you cannot control with the medicine
  • Cough, problems breathing, or chest pain
  • Lightheadedness or weakness
  • Pain and/or swelling in your feet, calves, or legs

If you think you have an emergency, call for medical help right away.

RESOURCES

American Heart Association  http://www.heart.org 

National Heart, Lung, and Blood Institute  https://www.nhlbi.nih.gov 

CANADIAN RESOURCES

Health Canada  https://www.canada.ca 

Heart and Stroke Foundation of Canada  http://www.heartandstroke.ca 

References

Femoral popliteal bypass. Stanford Health Care website. Available at: https://stanfordhealthcare.org/medical-treatments/f/femoral-popliteal-bypass.html. Accessed September 9, 2021.

Lower extremity bypass surgery. USCF Department of Surgery website. Available at: https://vascular.surgery.ucsf.edu/conditions--procedures/lower-extremity-bypass-surgery.aspx. Accessed September 9, 2021.

Peripheral artery disease (PAD) of lower extremities. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/peripheral-artery-disease-pad-of-lower-extremities. Accessed September 9, 2021.

Surgical bypass. Society for Vascular Surgery website. Available at: https://vascular.org/patient-resources/vascular-treatments/surgical-bypass. Accessed September 9, 2021.

Witcher A, Axley J, et al. Implementation of an enhanced recovery program for lower extremity bypass. J Vasc Surg. 2021 Feb;73(2):554-563.

Revision Information

  • Reviewer: EBSCO Medical Review Board Nicole Meregian, PA
  • Review Date: 07/2021
  • Update Date: 09/09/2021