Axillobifemoral bypass is a surgery to restore blood supply to the legs and feet if normal blood flow is blocked. Normally, blood that carries oxygen flows from the heart to the legs through a large blood vessel called the abdominal aorta. This blood vessel divides into arteries that run through the groin and supply blood to the legs (femoral arteries).

This procedure treats the problem by using an artificial blood vessel, also called a synthetic graft,to bypass the area of blocked blood flow. This graft creates a new path for blood to flow by connecting an artery in the arm (axillary artery)to the femoral artery in each leg.

Tell your health care provider about:

• Any allergies you have.

• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.

• Any problems you or family members have had with anesthetic medicines.

• Any bleeding problems you have.

• Any surgeries you have had.

• Any medical conditions you have.

• Whether you are pregnant or may be pregnant.

What are the risks?

What happens before the procedure?

What happens during the procedure?

• An IV will be inserted into one of your veins.

• You will be given one or more of the following:

  • A medicine to help you relax (sedative).

  • A medicine to numb the areas (local anesthetic).

  • A medicine to make you fall asleep (general anesthetic).

• To insert the graft, the surgeon will make an incision in your upper chest, near your shoulder. Other incisions will be made in your groin area.

• Your surgeon will make a tunnel just under your skin, passing down the side of your chest and belly to reach the incisions in the groin area.

• The graft will be passed through this tunnel, from the upper chest down to the groin area.

• Clamps will be placed to cut off blood supply to the arteries in your arm and in your legs.

• Openings will be made into the arteries.

• The top part of the graft will be sewn into the artery in the arm and the bottom ends of the graft will be sewn into the arteries in the legs.

• The clamps will be removed to allow blood to flow through the graft.

• Imaging studies using sound waves (ultrasound) will be used to check blood flow through the graft.

• The chest and groin incisions will be closed with stitches (sutures) or staples.

• Bandages (dressings) will be placed over the incisions.

The procedure may vary among health care providers and hospitals.

What happens after the surgery?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.

• You will be given medicine to treat pain, prevent infection, and prevent blood clots.

• You will need to stay in the hospital for several days.

• You will be encouraged to:

  • Get out of bed and start walking as soon as you are able. Bedrest may be required for up to 24 hours depending on your graft.

  • Do deep breathing exercises several times a day to prevent pneumonia.

  • Wear compression stockings to help prevent blood clots and reduce swelling in your legs.

• Your blood flow will be assessed by checking the color, temperature, and pulses in your legs and feet.

• Blood flow through the new graft may be checked with an ultrasound.

• Your surgery site will be checked often.

Summary

• Axillobifemoral bypass is a surgery to restore blood flow to your legs and feet.

• During this procedure, a blood vessel graft is attached to an artery that supplies blood to your arm and to arteries that supply blood to your legs.

• Follow instructions from your health care provider about taking medicines and about eating and drinking before the procedure.

• Plan to have a responsible adult care for you for the time that you are told.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.