Femoro Popliteal Bypass Graft

DR PS RAUTENBACH- Specialist Surgeon

M.B.Ch.B; DA; DipPEC; FCS

Patient Information: Femoro-Popliteal Bypass Graft Description: Femoral popliteal bypass surgery is used to treat blocked femoral artery. The femoral artery is the largest artery in the thigh. It supplies oxygen-rich blood to the leg. Blockage is due to plaque buildup or atherosclerosis. Atherosclerosis in the leg arteries causes peripheral vascular disease. The same process causes heart disease and stroke.

Reasons for a Femoro-Popliteal Graft:  Severe lack of blood supply to the lower limb. This may cause significant pain when walking.  Gangrene of the toes, or non-healing wounds or ulcers on the feet.

Preparation for the Operation:  Stop eating and drinking 6 hours before the procedure.  You should take all your regular medication as usual on the day.  Make sure your doctor knows what medicine you take, especially those that may cause blood clotting.  Your doctor may want you to stop certain medication such as disprin, warfarin, or other blood thinning medicines before the operation.

Is the procedure safe?

Your surgery will be performed by a team of highly qualified and skilled professionals who will take all steps necessary to ensure a safe procedure and a successful result. However there are risks involved with all surgery even if these risks may be small.

The Procedure:

The operation is done under general anaesthetic. The operation usually takes 3 hours. The large arteries in the groin and either above or below the knees are exposed through small incisions. A tunnel is made deep in the leg between these two incisions, and a new bypass graft, usually your own vein but sometimes synthetic material, is passes through the tunnel. The ends of the bypass are then joined to the arteries, supplying blood from the groin to the lower leg where it is needed.

Side effects or Complications: There are risks for developing complications which are general and which may occur with any surgical procedure. Complications may include:

 Infection, bleeding, pain, wound breakdown, deep vein thrombosis, or complications affecting the heart, lungs or kidneys.  Blockage of the new graft- These occur infrequently. Graft blockages require operation to remove the clot and restore flow  Wound infection requires antibiotics, and an operation to drain an abscess.  Cardiac (Rhythm disturbances, heart attack or heart failure).  Respiratory (partial collapse of one or both lungs – atelectasis, chest infection, fluid on the lungs).  Kidney problems (Kidney failure which may require dialysis, bladder infections, difficulty with passing water after the catheter is removed).

After the Operation:  Pain will be controlled with medicine.  You will be transferred to ICU. If there have been problems during the surgery that necessitate post-operative ventilation, then they will be explained to you once you are awake. You will have several drips in your arms and neck.  A catheter will be in your bladder.  Fluids will be increased over the next two to three days before introducing solids, when your surgeon feels that your bowels are ready. You will usually be able to eat normally once you have been discharged.  You should be able to go home upon your Surgeon’s assessment, but usually you will stay in hospital for 4-7 days.  Driving of a vehicle only after 4 weeks post-operative.  Returning to work can be after 4-6 weeks.  A RESPONSIBLE ADULT MUST DRIVE YOU HOME. YOU WILL NOT BE ABLE TO DRIVE FOLLOWING THIS PROCEDURE.

Info sheets give an overall guide to your procedure. There may be differences in the details of your treatment, since it is tailored to each patients’ medical condition at the time.