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Peripheral Vascular Bypass Surgery

What is peripheral vascular bypass surgery?

Peripheral vascular bypass surgery is surgery to improve blood flow when one or more of the arteries that supplies blood leg or arm are narrowed or blocked. A blood vessel from another part of your body or a man-made (synthetic) blood vessel, called a graft, will be used to make a detour for blood to flow through. One end of the graft will be stitched above the blockage in the artery. The other end will be stitched below the blockage. This will allow blood to bypass the blockage and provide oxygen-rich blood to the rest of the leg or arm. The most well known peripheral vascular bypass surgery is the femoral popliteal bypass graft surgery. This is surgery that bypasses a narrowed or blocked femoral artery in the groin or leg.

How is peripheral vascular bypass surgery done?

Before the procedure:

  • Your healthcare provider will ask you to sign a consent form for peripheral vascular bypass surgery. The consent form will state the reason you are having the procedure, what happens during the procedure, and what you may expect afterward.
  • Tell your healthcare provider if you are allergic to any medicines.
  • Tell your healthcare provider if you are taking any medicines, including nonprescription drugs, herbal remedies, or illegal drugs (if any).
  • You will have a needle (IV) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.

During the procedure:

  • You will be given a sedative, which will help you to relax. This is usually given in your vein (IV).
  • You will be given medicines to prevent pain during your surgery. These may include:
    • Local anesthesia: Numbs the area where the procedure will be done
    • Regional anesthesia: Numbs the lower half of your body while you remain awake. The epidural block is a commonly used type of regional anesthesia. For an epidural block, you are given a shot of pain-relieving medicine in the lower spinal area of your back. Usually a small tube is inserted into your back, inside the spinal canal, through the needle. Then the needle is removed, leaving the tube in place. More medicine can later be given through the tube instead of with another shot.
    • General anesthesia: Relaxes your muscles and puts you to sleep. A breathing tube is usually put in your throat when you have general anesthesia.
  • You may have a small tube (catheter) placed into your bladder through the urethra (the opening from the bladder to the outside of the body) to drain and measure urine from the bladder.
  • The surgeon will make a cut in the skin above the blood vessel that is blocked.
  • The graft blood vessel ends will be sewn into the areas above and below the blockage.  
  • The cut in your skin will be closed with stitches.

After the procedure:

  • You will be checked often by nursing staff.
  • There will be a dressing on the surgery site. The dressing will be checked and changed by your provider or the nursing staff as needed.
  • Your provider may prescribe medicine to:
    • Treat pain
    • Treat or prevent an infection
    • Help prevent blood clots
    • Slow the heart rate and reduce the workload of the heart
    • Relax and widen blood vessels and allow blood to flow through them easier
    • Control cholesterol levels
    • Reduce fluid build-up and swelling in the body
  • Your blood oxygen level may be monitored by a sensor that is attached to your finger or earlobe.
  • A cardiac (heart) monitor may be used to keep track of your heartbeat.

What can I do to help?

  • You will need to tell your healthcare team if you have new or worsening:
    • Bluish color of the skin of the arm or leg below the surgery
    • Chest discomfort (pressure, fullness, squeezing or pain) that lasts more than a few minutes or goes away and comes back, or chest discomfort that goes to your arms, neck, jaw or back
    • Fast, slow, or irregular heartbeat
    • Numbness in your feet or hands
    • Shortness of breath
    • Signs of infection around your surgical wound. These include:
      • The area around your wound is more red or painful
      • The wound area is very warm to touch
      • You have blood, pus, or other fluid coming from your wound area
      • You have chills or muscle aches
    • Swelling of your legs, ankles, or feet
    • Warmth, redness, or pain in your leg
    • Weakness, numbness, tingling or pain in your face, arm, or leg, especially on one side of your body
  • Ask questions about any medicine, treatment, or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many factors. The average amount of time to stay in the hospital after peripheral vascular bypass surgery is 5 to 7 days.

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