Medical knowledge, Patient Education
Femorofemoral Bypass
Femorofemoral bypass, or femoral-femoral bypass, is a surgery to improve blood flow (circulation) in the legs. You may need this procedure if your iliac artery is blocked. The iliac artery is one of the main blood vessels that supplies blood to the legs. One branch of the iliac artery (external iliac artery) becomes the femoral artery as it reaches the leg. The femoral artery is a common site of blockage.
During this procedure, an artificial blood vessel (prosthetic graft) is placed so that it connects the left and right femoral arteries to each other. This allows blood to flow around (bypass) the blocked part of the iliac artery, resulting in improved circulation to your leg.
Tell a 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?
-
Infection.
-
Bleeding.
-
Allergic reactions to medicines or dyes.
-
A blood clot that forms in the graft or the leg and blocks flow (thrombosis).
-
A blood clot may travel to the lung (pulmonary embolism) or the brain (stroke).
-
Damage to other structures or organs, such as nerve damage.
-
Heart attack.
What happens before the procedure?
When to stop eating and drinking
-
8 hours before your procedure
-
Stop eating most foods. Do not eat meat, fried foods, or fatty foods.
-
Eat only light foods, such as toast or crackers.
-
All liquids are okay except energy drinks and alcohol.
-
-
6 hours before your procedure
-
Stop eating.
-
Drink only clear liquids, such as water, clear fruit juice, black coffee, plain tea, and sports drinks.
-
Do not drink energy drinks or alcohol.
-
-
2 hours before your procedure
-
Stop drinking all liquids.
-
You may be allowed to take medicines with small sips of water.
-
If you do not follow your health care provider’s instructions, your procedure may be delayed or canceled.
Medicines
-
Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
-
Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
-
Taking over-the-counter medicines, vitamins, herbs, and supplements.
Tests
-
A physical exam.
-
Blood tests.
-
Tests to check your heart, such as an electrocardiogram (ECG).
-
Imaging tests of the arteries that supply blood to your legs (angiogram).
Surgery safety
-
How your surgery site will be marked.
-
What steps will be taken to help prevent infection. These steps may include:
-
Removing hair at the surgery site.
-
Washing skin with a germ-killing soap.
-
Receiving antibiotic medicine.
-
General instructions
-
Do not use any products that contain nicotine or tobacco for at least 4–6 weeks before the procedure. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your health care provider.
-
Ask your health care provider how long you will be staying in the hospital after your procedure.
-
Plan to have a responsible adult:
-
Take you home from the hospital or clinic. You will not be allowed to drive.
-
Care for you for the time you are told.
-
What happens during the procedure?
-
An IV will be inserted into one of your veins.
-
In most cases, you will be given a medicine to make you fall asleep (general anesthetic). If general anesthesia is not safe for you because of a heart or lung condition, you will be given one or more of the following:
-
A medicine to help you relax (sedative).
-
A medicine to numb the area (local anesthetic).
-
A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
-
-
You will be given medicine through your IV to prevent blood clots.
-
To insert the graft, the surgeon will make an incision on each side of your groin, above your left and right femoral arteries.
-
The femoral arteries will be located.
-
A tunnel will be made to connect the two incisions.
-
A prosthetic graft will be threaded through the tunnel. In some cases, a human blood vessel may be used for the graft.
-
Your femoral arteries will be clamped above your incisions to temporarily stop blood flow.
-
A hole will be made in each femoral artery.
-
The ends of the graft will be stitched (sutured) onto the holes in the left and right femoral arteries.
-
The femoral artery clamps will be removed.
-
To make sure blood is flowing through the graft, an imaging test (ultrasound) may be done. Your surgeon may also check the pulses in your feet.
-
Your incisions will be closed with sutures or staples.
-
Your incisions may be covered with bandages (dressings).
The procedure may vary among health care providers and hospitals.
What happens after the procedure?
-
Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
-
You will be encouraged to:
-
Get out of bed and start walking as soon as you are able.
-
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.
-
-
You will be given medicines to treat pain, prevent infection, and prevent blood clots.
-
Your blood flow will be assessed by checking the color, temperature, and pulses in your legs and feet.
-
Your surgery site will be checked often.
Summary
-
Femorofemoral bypass, or femoral-femoral bypass, is a surgery to improve blood flow (circulation) in the legs.
-
During the procedure an artificial blood vessel (prosthetic graft) is placed so that it connects the left and right femoral arteries to each other.
-
Follow instructions from your health care provider about taking medicines and about eating and drinking before the procedure.
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.
