What is femoropopliteal bypass surgery?

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Femoropopliteal bypass surgery: Overview

A femoropopliteal bypass is a type of surgery. It is also called a fem-pop or leg artery bypass. This type of surgery redirects blood around a narrowed or blocked blood vessel in your leg. So it may improve the blood flow in your leg. This can decrease leg pain, numbness, and cramping.

Your doctor will use something called a graft to make the blood go around (bypass) the narrowed or blocked part of your blood vessel. The graft may be a vein taken from another place in your leg. Or it may be a human-made graft.

You may be asleep during the surgery. But it also can be done while you are awake. If you are awake, you will get medicine to numb your leg and prevent pain. First, the doctor makes cuts in your thigh and sometimes in the side of the calf. These cuts are called incisions. If one of your veins is being used for the graft, the doctor will make other incisions in your leg. Then the doctor will attach one end of the graft to the femoral artery in your thigh. The other end will be attached to the popliteal artery above or below your knee. After the graft is in place and blood is flowing through it, the doctor uses stitches or staples to close the incisions. You will have scars, but they will fade with time.

You will probably stay in the hospital for at least 2 days. For at least 2 to 6 weeks, you will need to take it easy at home. It may take 6 to 12 weeks to fully recover.

How can you care for yourself after femoropopliteal bypass surgery?

Activity

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Try to walk each day or as often as your doctor tells you. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
  • Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.
  • Ask your doctor when you can drive again.
  • If you work, you may need to take 2 to 6 weeks off, depending on your job.

Diet

  • Eat heart-healthy foods. These include fruits, vegetables, and whole grains. If you have not been eating this way, talk to your doctor. You also may want to talk to a dietitian. This expert can help you learn about healthy foods and plan meals.
  • Drink plenty of fluids (unless your doctor tells you not to).
  • You may notice that your bowel movements are not regular right after your surgery. This is common. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
  • Take pain medicines exactly as directed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
  • Your doctor may prescribe a blood thinner when you go home. This helps prevent blood clots. Be sure you get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems.

Incision care

  • If you have bandages on the incisions, follow your doctor's instructions about changing them.
  • If you have strips of tape on the incisions, leave the tape on for a week or until it falls off.
  • Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it oozes or rubs against clothing. Change the bandage every day.
  • You may shower if your doctor says it is okay. Do not take a bath for the first 2 weeks or until your doctor tells you it is okay.

Elevation

  • Prop up your leg on a pillow anytime you sit or lie down for the first 3 days. Try to keep it above the level of your heart. This will help reduce swelling.

How well does femoropopliteal bypass for peripheral arterial disease work?

Fem-pop bypass surgery can improve blood flow and relieve intermittent claudication.

How do you prepare for femoropopliteal bypass surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

What are the risks of femoropopliteal bypass surgery?

All surgeries carry a certain amount of risk. These risks include:

  • Infection.
  • Bleeding.
  • Heart attack or stroke.

Specific risks for this bypass surgery include:

  • Leg swelling.
  • Failed or blocked grafts.

What is femoropopliteal bypass surgery?

A femoropopliteal (fem-pop) bypass is surgery to change the flow of your blood so it goes around narrowed or blocked blood vessels.

To do this surgery, your doctor will use something called a graft. The graft can be a vein taken from another place in your leg. Or it can be a human-made graft.

The doctor sews the graft onto your femoral and popliteal arteries. Then your blood goes through this new graft vessel instead of the narrowed or blocked one.

After femoropopliteal bypass: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have trouble breathing.

Call your doctor now or seek immediate medical care if:

  • You have sudden symptoms in your leg or foot such as severe pain, numbness, weakness, tingling, cool skin, or skin color changes. Your skin may be pale, bluish, or purplish.
  • You have pain that does not get better after you take pain medicine.
  • You have loose stitches, or your incisions come open.
  • You are bleeding a lot from the incisions.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
  • You are sick to your stomach or cannot keep fluids down.

Watch closely for any changes in your health, and be sure to contact your doctor if:

  • You do not get better as expected.

What can you expect as you recover from femoropopliteal bypass surgery?

You will probably stay at least 2 days in the hospital.

You will have some pain from the incisions. This usually gets better after about 1 week.

Your leg may be swollen at first. This is normal. It may last 2 or 3 months.

You will need to take it easy for at least 2 to 6 weeks at home. It may take 6 to 12 weeks to fully recover.

You may need to take at least 2 to 6 weeks off from work. It depends on the type of work you do and how you feel.

You will have regular tests to check for problems with the graft.

After femoropopliteal bypass surgery: Overview

Femoropopliteal bypass surgery is used to bypass diseased blood vessels above or below the knee. Your doctor used something called a graft to make the blood go around (bypass) the narrowed or blocked part of your blood vessel.

You will have some pain from the cuts (incisions) the doctor made. This usually gets better after about 1 week. Your doctor will give you pain medicine for this. You can expect your leg to be swollen at first. This is a normal part of recovery and may last 2 or 3 months.

You will have stitches or staples in the incisions. If you have stitches, they may dissolve on their own. Or your doctor may take them out 7 to 14 days after your surgery.

You will need to take it easy for 2 to 6 weeks at home. It may take 6 to 12 weeks to fully recover.

After surgery, blood may flow better throughout your leg, which can decrease leg pain, numbness, and cramping. You will need to have regular checkups with your doctor to make sure the graft is working.

Femoropopliteal (fem-pop) bypass

Blocked artery and position of graft in femoropopliteal bypass.

Femoropopliteal (fem-pop) bypass surgery is used to bypass narrowed or blocked arteries above or below the knee. The bypass improves blood flow to the leg.

To bypass a narrowed or blocked artery, blood is redirected through a graft. The graft is either a healthy blood vessel that has been transplanted or a human-made material. This graft is sewn onto both the femoral and popliteal arteries so that blood can travel through the graft and around the diseased part.

What happens on the day of your femoropopliteal bypass surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
  • The surgery may take at least 2 hours.

Why is femoropopliteal bypass surgery done?

Fem-pop bypass is for people who have narrowed or blocked femoral or popliteal arteries, which are arteries in the legs. Usually the blockage must be causing significant symptoms or be limb-threatening before bypass surgery is considered.

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