Why is surgery needed?
A large blood vessel (artery) in your leg has become narrowed or blocked so less blood and oxygen is getting to the tissues in that leg and foot.
Surgery is needed to restore blood flow to your leg and foot. Without surgery, your symptoms can become worse. Your leg may become numb or weak. You may develop infection or gangrene and be at risk of losing your leg.
Why did the artery get narrow or blocked?
Over time, a fatty material called plaque has built up inside your arteries. This process is called atherosclerosis (hardening of the arteries). Blood flow slows down because plaque is in the way.
Why did the plaque build-up?
There are risk factors that increase your chance of developing plaque over time. Eating healthy, exercising regularly, and taking medication can help lower your risk.
Smoking
- Cigarettes, pipes, cigars and chewing tobacco all cause plaque build-up in your arteries. The chemicals damage the inner lining of your arteries and increase your risk for atherosclerosis. If you smoke, quitting is the best thing you can do for your health.
Diet
- High cholesterol contributes to plaque build-up. Eating foods with less cholesterol and trans fats and eating foods with more fiber can lower your risk.
High blood pressure
- High blood pressure that is not controlled or treated is called hypertension. Hypertension puts stress on your heart, arteries and kidneys. Eating less salt, taking your medications, exercising, and relieving stress can keep your blood pressure in a healthy range.
Diabetes
- If you have diabetes, you are at a higher risk for developing plaque in your arteries. High blood sugar levels can damage your heart, blood vessels, kidneys, eyes and nerves. It is important to follow the advice of your health care team about managing your blood sugars.
What types of surgery can help?
Your femoral artery brings blood to your leg, foot and toes. Two types of surgery on this artery can help improve blood flow in the legs:
Repair: A narrow or blocked artery in the leg is cleaned out or repaired to improve blood flow. Your surgeon will make a cut in your leg near the blockage in your femoral artery and carefully take the plaque off the walls. This will help your leg, foot and toes get blood. All cuts will be closed with stitches or staples.
Bypass: A new tube is made to make blood go around (bypass) the narrow or blocked section of the artery.
How does leg bypass surgery help?
Leg bypass surgery creates a new tube for blood to flow to your leg and foot, bypassing (avoiding) the section of the artery that is narrow or blocked. The new tube is called a graft. A graft can be a vein from your leg or arm (if suitable) or a flexible, artificial tube. Leg bypass surgery can be done in a few ways:
- Femoral-popliteal bypass: An incision (cut) is made from your groin area to your knee or further down your leg. One end of the graft is attached to the artery at the top of your leg. The other end is attached to an artery in your lower leg. The blood now flows through the graft, instead of through the section of the artery that was narrow or blocked. Improving the blood flow to your foot can relieve pain and help to heal any open areas (ulcers) on your foot. This surgery usually takes 3 to 4 hours.
- Femoral to femoral bypass: Incisions (cuts) are made in your groin area. One end of the graft is attached to the main artery in your good leg. The other end is attached to the main artery in your bad leg. The blood now flows through the graft from your good leg to your bad leg, bypassing the blocked section of the artery. The artery in your good leg will supply blood to both legs. One end of the graft is attached to the main artery in your good leg. The other end is attached to the main artery in your bad leg. The blood now flows through the graft from your good leg to your bad leg, bypassing the blocked section of the artery. The artery in your good leg will supply blood to both legs.
- Aorto-bifemoral bypass: If an aorto-bifemoral bypass is planned, an incision in the middle of your abdomen and an incision in each groin will be added. This surgery is more stressful on your body than a standard bypass and may involve a longer hospital stay to allow your bowels to recover. You may not be able to eat for 2-3 days. You will gradually be able to walk, and we expect you to feel better after the third or fourth day.
- Axillo-bifemoral bypass: If an axillo-bifemoral bypass is planned, an incision will be added to the area under the clavicle on the right or the left in addition to the groin incisions.
Can I tolerate a big operation?
Our vascular surgeons work very closely with your primary provider and your cardiologist to optimize your health before the operation and to ensure that you have a smooth and uneventful recovery.
You will receive a booklet detailing all the information and instructions for before, during and after your admission to the hospital.
At South Charlotte General and Vascular Surgery, we are committed to your vascular health. Please, let us know if your experience with us has been less than perfect.
