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Peripheral artery bypass is surgery to reroute the blood supply around a blocked artery in one of your legs. Fatty deposits can build up inside the arteries and block them.
A graft is used to replace or bypass the blocked part of the artery. The graft may be a plastic tube, or it may be a blood vessel (vein) taken from your body (most often the opposite leg) during the same surgery.
Peripheral artery bypass surgery can be done in one or more of the following blood vessels:
Aorta (the main artery that comes from your heart)
Artery in your hip
Artery in your thigh
Artery behind your knee
Artery in your lower leg
Artery in your armpit
Symptoms of a blocked peripheral artery are pain, achiness, or heaviness in your leg that starts or gets worse when you walk.
You may not need bypass surgery if these problems happen only when you walk and then go away when you rest. You may not need this surgery if you can still do most of your everyday activities. Your doctor can try medicines and other treatments first.
Reasons for having arterial bypass surgery of the leg are:
You have symptoms that keep you from doing your everyday tasks.
Your symptoms do not get better with other treatment.
You have skin ulcers (sores) or wounds on your leg that do not heal.
You have an infection or gangrene in your leg.
You have pain in your leg from your narrowed arteries, even when you are resting or at night.
Before having surgery, your doctor will do special tests to see the extent of the blockage.
Risks for this surgery are:
Bypass does not work
Damage to a nerve that causes pain or numbness in your leg
Damage to nearby organs in the body
Damage to the bowel during aortic surgery
Infection in the surgical cut
Injury to nearby nerves
Sexual problems caused by damage to a nerve during aortofemoral or aortoiliac bypass surgery
Surgical cut that opens up
Need for a second bypass surgery or a leg amputation
PAD is a common disorder. It most often affects men over age 50, but women can have it as well. People are at higher risk if they have a history of:
Heart disease (coronary artery disease)
High blood pressure (hypertension)
Kidney disease involving hemodialysis
Stroke (cerebrovascular disease)
The main symptoms of PAD are pain, achiness, fatigue, burning, or discomfort in the muscles of your feet, calves, or thighs. These symptoms most often appear during walking or exercise, and go away after several minutes of rest.
At first, these symptoms may appear only when you walk uphill, walk faster, or walk for longer distances.
Slowly, these symptoms occur more quickly and with less exercise.
Your legs or feet may feel numb when you are at rest. The legs also may feel cool to the touch, and the skin may look pale.
When PAD becomes severe, you may have:
Pain and cramps at night
Pain or tingling in the feet or toes, which can be so severe that even the weight of clothes or bed sheets is painful
Pain that is worse when you elevate your legs, and improves when you dangle your legs over the side of the bed
Skin that looks dark and blue
Sores that do not heal
Things you can do to control PAD include:
Balance exercise with rest. Walk or do another activity to the point of pain and alternate it with rest periods. Over time, your circulation may improve as new, small blood vessels form. Always talk to the provider before starting an exercise program.
Stop smoking. Smoking narrows the arteries, decreases the blood’s ability to carry oxygen, and increases the risk of forming clots (thrombi and emboli).
Take care of your feet, especially if you also have diabetes. Wear shoes that fit properly. Pay attention to any cuts, scrapes, or injuries, and see your provider right away. Tissues heal slowly and are more likely to get infected when there is decreased circulation.
Make sure your blood pressure is well-controlled.
If you are overweight, reduce your weight.
If your cholesterol is high, eat a low-cholesterol and low-fat diet.
Monitor your blood sugar level if you have diabetes, and keep it under control.
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