Surgical Treatment

Bypass surgery for atherosclerosis/PAD/PVD

A surgical bypass reroutes blood flow around a blocked blood vessel by creating a new pathway for blood flow using a graft.

Why is this procedure performed? Why do I need this procedure?

The goal of treatment is to re-direct the blood flow in the artery to bypass a blockage. You may need this procedure if your arteries become too narrowed or blocked from plaque inside the artery walls. If arteries are blocked, blood cannot get through to nourish the tissues, causing the muscles of the lower extremities to cramp and lose strength. In severe cases, you may develop pain or develop ulcers on your feet.

Each patient is evaluated, and treatment will be individualized for the patient's circumstances.

Where is the procedure performed and who performs this procedure?

This procedure is performed in the hospital surgical suite by a vascular surgeon.

What are the risks and potential complications of the procedure?

Your doctor will discuss the specific risks and potential benefits of the recommended procedure with you.

Bypass surgery usually has no complications, but there may be a risk of injury to the blood vessel, mild leg swelling or wound complications. Your vascular surgeon will discuss the important risks and benefits with you.

Special precautions are taken to decrease these risks, and there may be other possible risks. When you meet with your doctor, please ask questions to make sure you understand the risks of the procedure and why the procedure is recommended.

How do I prepare for the procedure?

A few days before the procedure, pre-procedure tests may be performed to ensure that it is safe to perform the surgery. You may need to discontinue certain medications before the procedure. Your health care team will provide specific instructions to help you prepare for the procedure.

What happens during the procedure?

The surgical bypass will be performed under general anesthesia. To bypass the blockage, the surgeon makes a small opening just below the blockage in the diseased artery and places a graft, which is either a portion of one of your veins or a man-made synthetic tube. The surgeon will connect the graft above and below the blockage to allow blood around the blockage.

How long does the procedure last?

The procedure itself generally takes three to five hours, but the preparation and recovery time add several hours. The surgery may require a minimum hospital stay of four to seven days.

What happens after the procedure?

Some patients require admission to an intensive care unit for close monitoring for about one to two days after the surgery, but this is not routine. Once the patient is transferred to the nursing unit, the hospital stay is about three to seven more days. Most patients will receive physical therapy during the recovery period.

Are there any side effects of the treatment?

As with any surgical procedure, you will feel somewhat tired for a few weeks. You will have mild pain along the incisions, and you may experience mild leg swelling.

Surgery is required less often today, as better preventative anti-atherosclerotic medications and techniques have become available for treating blocked or damaged arteries. With modern treatments, surgery is required only for very severe atherosclerosis unresponsive to medications and angioplasty.