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Aortobifemoral Bypass for Peripheral Arterial Disease

Surgery Overview

Aortobifemoral bypass surgery is used to bypass diseased large blood vessels in the abdomen and groin.

To bypass a narrowed or blocked blood vessel, blood is redirected through a graft made of synthetic material (such as polytetrafluoroethylene [PTFE] or Dacron). This graft is sewn above and below the diseased artery so that blood flows through the graft. These man-made grafts are more likely to be used than transplanted natural grafts for aortobifemoral surgery, because the blood vessels involved are large.

The artificial blood vessel is formed into a Y shape. The single end of the Y is sewn on the aorta. The two split ends of the Y are sewn below the blocked or narrowed areas of the femoral arteries. This allows the blood to travel around (bypass) the diseased areas.

General anesthesia is used and will cause you to sleep through the procedure.

What To Expect

You may stay in the hospital 4 to 7 days. And you can expect your belly and groin to be sore for several weeks. You will probably feel more tired than usual for several weeks.

You may be able to do many of your usual activities after 4 to 6 weeks. But you will likely need 2 to 3 months to fully recover, especially if you typically do a lot of physical activities.

You will probably need to take at least 4 to 6 weeks off from work. It depends on the type of work you do and how you feel.

Why It Is Done

Aortobifemoral bypass surgery is for people who have narrowed or blocked blood vessels (aorta or iliac arteries) in the abdomen and pelvis. Usually the disease must be causing significant symptoms or be limb-threatening before bypass surgery is considered.footnote 1, footnote 2

How Well It Works

Bypass surgery can restore blood flow and relieve intermittent claudication.footnote 1, footnote 2

Risks

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

  • Infection from the incision.
  • Bleeding.
  • Heart attack or stroke.

Specific risks for aortobifemoral bypass surgery include:

  • Leg swelling.
  • Failed or blocked grafts.
  • Sexual dysfunction caused by nerve damage in the pelvis.

What To Think About

Your doctor may recommend that you try an exercise program and medicine before he or she recommends that you have this surgery.

References

Citations

  1. Gerhard-Herman MD, et al. (2016). 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease. Circulation, published online November 13, 2016. DOI: 10.1161/CIR.0000000000000471. Accessed November 25, 2016.
  2. Conte MS, et al. (2015). Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: Management of asymptomatic disease and claudication. Journal of Vascular Surgery, 61(3S): 2S–41S. DOI: 10.1016/j.jvs.2014.12.009. Accessed November 25, 2016.

Credits

ByHealthwise Staff
Primary Medical ReviewerRakesh K. Pai, MD - Cardiology, Electrophysiology
Martin J. Gabica, MD - Family Medicine
Adam Husney, MD - Family Medicine
E. Gregory Thompson, MD - Internal Medicine
David A. Szalay, MD - Vascular Surgery

Current as ofDecember 6, 2017


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