Bypass surgery in the leg arteries may be used to treat severe or limb-threatening peripheral arterial disease (PAD) that is causing symptoms. Bypass surgery redirects blood through a grafted blood vessel to bypass the blood vessel that is damaged. The grafted blood vessel may be a healthy natural vein or artery, or it may be man-made.

You may need surgery if you have symptoms of intermittent claudication and one of the following conditions:

• Your lifestyle or job is limited because of your symptoms.
• Exercise has not relieved your symptoms.
• Medicines have not relieved your symptoms.

The methods of bypass surgery vary depending on the size of the affected artery and the location of the artery.

Surgery Choices

The types of surgery used to treat PAD are categorized according to the location of the affected leg artery or arteries. See a picture of peripheral arterial disease of the legs.

• Aortobifemoral bypass is done for PAD that affects the major abdominal artery (aorta) and the large arteries that branch off of it. See a picture of aortobifemoral bypass.
• Femoropopliteal (fem-pop) bypass is done for PAD that affects the arteries above and below the knee. See a picture of femoropopliteal bypass.
• Femoral-tibial bypass is done for PAD that affects the arteries in the lower leg or foot. See a picture of femoral-tibial bypass.

Should I have surgery (angioplasty or bypass surgery) for peripheral arterial disease?

What to Think About

Surgery for peripheral arterial disease is used for people who have disabling intermittent claudication; pain when at rest; open sores (ulcers) that won't heal; or dying skin, muscle, bone, and nerve tissue in their legs or feet (gangrene).

In rare cases, some people need to have a leg, foot, or part of the foot amputated. Over a year's time, less than 1% of people with intermittent claudication need to have amputation for peripheral arterial disease that gets worse.¹ People with diabetes are at increased risk for amputation. Amputation is used only when the damage is very severe, possibly life-threatening, and after all other treatment options have been tried.

In rare cases, a blood clot in an artery can suddenly and completely block blood flow to a leg or foot. Often, severe pain, numbness, and coldness develop within 1 hour. This blockage is an emergency. Clot-dissolving medicines, surgical removal of the clot, or bypass surgery is needed to restore blood flow.