Femoropopliteal Bypass (Fem-Pop Bypass) for Peripheral Arterial Disease
Femoropopliteal (fem-pop) bypass surgery is used to bypass diseased
blood vessels above or below the knee.
To bypass the blocked blood vessel, blood is redirected through
either a healthy blood vessel that has been transplanted or a man-made graft
material. This vessel or graft is sewn above and below the diseased artery so
that blood flows through the new vessel or graft.
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Before you have surgery, the doctor will determine what type of
material is best suited to bypass the blood vessel. Whenever possible, the
surgeon will choose to use an existing piece of vein taken from the same leg.
Man-made graft materials (such as polytetrafluoroethylene [PTFE] or Dacron) are
more likely to become narrowed again, but they are still effective.
The section of vein or man-made blood vessel graft is sewn onto
both the femoral and popliteal arteries so that blood can travel through the
new graft vessel and around the existing blockage(s). See a picture of a
femoropopliteal (fem-pop) bypass.
General anesthesia or an injection in the spine (epidural) is used
for this surgery. General anesthesia will cause you to sleep through the
procedure. An epidural prevents pain in the lower part of the body.
What To Expect After Surgery
You will likely stay in the hospital 2 to 4 days after surgery. You can
begin sitting up and walking the first day after surgery.
You will have some pain from the cuts (incisions) the doctor made. This usually gets better after about 1 week. You can expect your leg to be swollen at first. This is a normal part of recovery and may last 2 to 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 will probably 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 need to have regular checkups with your doctor to make sure the graft is working.
Why It Is Done
Fem-pop bypass is for people who have narrowed or blocked femoral
or popliteal arteries, which are near the surface of the legs. Usually the
blockage must be causing significant symptoms or be limb-threatening before
bypass surgery is considered.
How Well It Works
This surgery relieves
intermittent claudication in about 80 out of 100 people for at
least 5 years when an existing vein is used.1
When a vein is used, the bypass remains open in about 66 out of 100 people 5 years after
surgery. When a man-made graft is used, the bypass remains open in 33 to 50 out of 100 people 5
years after surgery.2
All surgeries carry a certain amount of risk. These risks include:
De Vries SO, Hunink MG (1997). Results of aortic
bifurcation grafts for aortoiliac occlusive disease: A meta-analysis.
Journal of Vascular Surgery, 26(4): 558-569.
Hirsch AT, et al. (2006). ACC/AHA 2005 practice
guidelines for the management of patients with peripheral arterial disease
(lower extremity, renal, mesenteric, and abdominal aortic): A collaborative
report from the American Association for Vascular Surgery/Society for Vascular
Surgery, Society for Cardiovascular Angiography and Interventions, Society for
Vascular Medicine and Biology, Society of Interventional Radiology, and the
ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop
Guidelines for the Management of Patients With Peripheral Arterial Disease):
Endorsed by the American Association of Cardiovascular and Pulmonary
Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular
Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease
Foundation. Circulation, 113(11): e463-e654.
Primary Medical Reviewer
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Specialist Medical Reviewer
David A. Szalay, MD - Vascular Surgery
October 14, 2011
WebMD Medical Reference from Healthwise
October 14, 2011
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