A femoropopliteal bypass is a surgery to allow blood to go around (bypass) a blocked artery in the leg. The artery may become blocked with plaque, which is a buildup of fat. Arteries carry blood that brings oxygen and nutrients to the body. The femoral artery is in the upper part of the leg. It is the main artery that carries blood to the leg. Popliteal arteries are in the back of the knee. These arteries take blood to the lower part of the leg.

In this procedure, a graft is put in to bypass the blocked artery. The graft can be one of your own veins that has been taken from another part of your leg, or it can be made of a manufactured material, such as plastic or fabric.

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?

Generally, this is a safe procedure. However, problems may occur, including:

Infection.
Bleeding.
Allergic reactions to medicines or dyes.
Blood clots that form in the graft or the leg and block blood flow (thrombosis).
A blood clot may travel to the lungs (pulmonary embolism) or to 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

Follow instructions from your health care provider about what you may eat and drink before your procedure. These may include:

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

Ask your health care provider about:

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

You may have an exam or testing. These may include:

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).

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 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.
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?

The process for a femoropopliteal bypass, including the autograft and bypass graft.

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 area (local anesthetic).
- A medicine to make you fall asleep (general anesthetic).
- A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
A small, thin tube (catheter) may be placed into your bladder to drain urine during and after the procedure.
If the graft will come from one of your own veins (autograft):
- An incision will be made in your leg near the portion of the autograft vein that will be used.
- After the autograft is removed, this incision will be closed.
To insert the graft, the surgeon will:
- Make an incision in your groin area so he or she can locate your femoral artery.
- Place a clamp above the area where the femoral artery is blocked.
- Sew the graft into the artery above the blocked area.
- Make another incision lower in the leg over the popliteal artery. This is usually behind the knee.
- Place a clamp on the popliteal artery and then bring the other end of the graft down under the skin between the two incisions.
- Sew the free end of the graft into the popliteal artery.
- Remove the clamps and check the attachments for leaking.
You may have an X-ray done after a dye is injected (arteriogram). This is to check the blood flow through the graft.
The incisions will be closed with stitches (sutures) or staples.
Bandages (dressings) will be applied to the area.

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 may be given medicine to treat pain, prevent infection, and prevent blood clots.
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.
Your surgery site will be checked often to make sure that you have good blood flow in your leg. Health care providers will:
- Feel for a pulse on your foot.
- Check your leg for changes in color and temperature and for decreased feeling (sensation) and movement.

Summary

A femoropopliteal bypass is a surgery to allow blood to go around (bypass) a blocked artery in the leg.
The graft can be one of your own veins that has been taken from another part of your leg, or it can be made of a manufactured material, such as plastic or fabric.
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.

Medical knowledge, Patient Education

Femoropopliteal Bypass

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What are the risks?