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Date issued: December 2023

Review date: December 2025

Ref: A-599/JW/Cardiology/Femoropopliteal and Femorodistal Bypass

PDF:  Femoropopliteal and Femorodistal Bypass.pdf [pdf] 213KB

Why do I need the operation?

There is a blockage of the artery supplying your leg, and the circulation of blood to your leg is reduced. The operation is to bypass the blocked artery in the leg so that the blood supply is improved.

What does the operation involve?

An incision is made in your groin and to expose the femoral artery. A second incision is made to the artery below the blockage.

The blocked part of the artery is then bypassed using either one of your own veins or a synthetic tube. The bypass tube is joined with the arteries above and below the blockage.

Your wounds will either be closed with absorbable sutures that do not need to be removed, or non dissolvable clips or sutures that will need to be removed in 10 days.

After the Operation

You will return to the ward. You may be given fluids by a drip in one of your veins until you are well enough to sit up and take fluids and food by mouth.

The nurses and doctors will try and keep you free of pain by giving pain killers. You may also have a catheter in your bladder.

Within a day or so, the drip, and bladder catheter will be removed. You will gradually become more mobile until you are fit enough to go home.

You may be visited by the physiotherapists after your operation. They will help you with your breathing to prevent you developing a chest infection and with your mobilisation to get you walking again.

Your wounds will be checked by the doctors on the ward and redressed if needed before you are discharged.

Complications

Chest infections: (Common)

Wound infection: (Rare) may require treatment with antibiotics.

Graft infection (Very rare), the artificial graft may become infected. This is a serious complication and usually treatment involves removal of the graft, with a reduction in the blood supply to the leg.

Fluid leak from wound: (Common) Occasionally the wound may leak fluid. It normally settles in time and does not usually indicate a problem with the bypass itself.

Bowel problems: (Common) Occasionally, the bowel is slow to start working again after the operation.

Major Complications: (Uncommon)As with any major operation, there is a small risk of you having a medical complication such as a heart attack, stroke, kidney failure, chest problems, loss of circulation in the legs or bowel or infection in the artificial artery.

Bypass blockage: (Rare) it will usually be necessary to perform another operation to clear the bypass.

Limb loss: (Very occasionally) when the bypass blocks, and the circulation cannot be restored, the circulation of the foot is so badly affected that amputation is required.

Limb swelling: (Common) It is normal for the leg to swell after this operation. The swelling usually lasts for about 2-3 months.

Skin sensation: You may have patches of numbness around the wound or lower down the leg which is due to the inevitable cutting of small nerves to the skin. This can be permanent but usually gets better within a few months.

Going home

If your stitches or clips are of the type that need removing we will arrange for your GP’s practice or district nurse to remove them and check your wound.

You may feel tired for some weeks after the operation but this should gradually improve as time goes by.

Regular exercise such as a short walk combined with rest is recommended for the first few weeks following surgery followed by a gradual return to your normal activity.

Driving: You will be deemed safe to drive when you are able to perform an emergency stop. This will normally be 2-4 weeks after surgery but, if in doubt, check with your own doctor.

Bathing: Once your wound is dry you may bathe or shower as normal.

Work: You should be able to return to work within 6-12 weeks of surgery. We will provide you with a sick note but if you need longer off work, please see your GP.

Medicines: You will usually be sent home on a small dose of aspirin if you were not already taking it. This is to make the blood less sticky. If you are unable to tolerate aspirin, an alternative drug may be prescribed.

Who to contact If I have any concerns?

Less than 24 hours post discharge:

Call 01752 202082 and ask for the ward you were discharged from.

After 24 hours post discharge-

Urgent Medical Help- 111 or 999

Pain/ medication concerns: GP

Operation specific questions: Consultant’s Secretary or Vascular Specialist Nurse

Consultant Vascular Surgeon and Lead Clinician

Mr Devender Mittapalli

Secretary: 01752 431822

Consultant Vascular and Transplant Surgeon

Mr Jamie Barwell

Secretary: 01752 431822

Consultant Vascular Surgeon

Surgeon Commander Cris Parry RN

Secretary: 01752 431822

Consultant Vascular Surgeon

Miss Catherine Western

Secretary: 01752 431805

Consultant Vascular Surgeon

Lt Col Robert Faulconer

Secretary: 01752 431805

Consultant Vascular Surgeon

Mr Hashem Barakat

Secretary: 01752 431822

Vascular Nurse Specialist

Mr Alan Elstone

Miss Jess Webster

01752 431805

What can I do to help myself?

• Quit Smoking

• Lower Cholesterol

• Keep active

• Control blood sugar levels in diabetes

• Maintain a healthy diet

• Maintain a healthy blood pressure

The nurse looking after you will be able to give you information/resources for any of these that are relevant to you.