During femoropopliteal bypass graft surgery, a vein or an artificial tube is used to create a bypass around a blocked main leg artery. The blocked arteries in the legs are usually caused by a buildup of plaque. When this buildup occurs, it is called peripheral arterial disease (PAD).
Femoropopliteal bypass graft may be done to:
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Your doctor will likely do the following:
Leading up to the surgery:
You may be given:
The doctor will make a cut in the skin on the leg. Through this cut, the doctor will take out a vein that will be used to make the bypass. If the vein cannot be used, then an artificial vein is used.
Next, an incision will be made in the groin to 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, and the other end will be stitched into the popliteal artery. Once attached, blood will be passed through the graft to check for leaks. If leaks are found, the doctor will repair them. The clamps will then be removed. This will allow blood to flow through the graft to the lower leg. The doctor will use stitches to close the incisions.
In some cases, a vein in the thigh will be used as a graft while left in place. This is called in situ. In this procedure, the valves inside the vein will be removed with a small scope and a small cutting tool. The vein will then be attached to the arteries to form a graft.
After the procedure you may be given:
As you heal and the swelling in your leg subsides, you may have pain for weeks or even months. Pain can be managed with medications. Keep in mind that it is normal for your leg to remain swollen for 2-3 months.
While you are recovering at the hospital, you may be instructed to:
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chances of infection such as:
It may take up to 4-6 weeks (or more) to feel pain free. If advised by your doctor, walk every day to make your legs stronger. You may be referred to a physical therapist to help with exercises. At home, you will need to take care of the wound to prevent infection. Your doctor may advise lifestyle changes, such as quitting smoking and a eating healthful diet.
It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:
If you think you have an emergency, call for emergency medical services right away.
American Heart Association
National Heart, Lung, and Blood Institute
Heart and Stroke Foundation of Canada
Lower extremity bypass surgery. USCF Department of Surgery website. Available at: https://vascular.surgery.ucsf.edu/conditions--procedures/lower-extremity-bypass-surgery.aspx. Accessed November 30, 2017.
Peripheral vascular bypass surgery. Encyclopedia of Surgery website. Available at: http://www.surgeryencyclopedia.com/Pa-St/Peripheral-Vascular-Bypass-Surgery.html. Accessed November 30, 2017.
Surgical bypass. Society for Vascular Surgery website. Available at: https://vascular.org/patient-resources/vascular-treatments/surgical-bypass. Accessed November 30, 2017.
Last reviewed November 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC Last Updated: 12/20/2014