Atherosclerosis is a disease affecting the arteries, which results in them narrowing or ‘hardening’. This happens when abnormal fatty material (called atheroma) coats the inside of the artery.
When the arteries to your legs are affected, you will experience pain in the back of your legs. If the blood supply continues to get worse, you may develop ulcers or even gangrene of the toes or feet.
What are the benefits of surgery?
If the operation is successful, you should be able to walk with less pain. Surgery should improve the blood supply to your legs and prevent you from getting ulcers or gangrene.
Are there any alternatives to surgery?
An angioplasty (stretching the artery with a balloon) is another treatment but will usually have been tried (if appropriate) before surgery is recommended.
What does the operation involve?
A variety of anaesthetic techniques are possible. The operation usually takes between one and five hours.
Your surgeon will make a cut in your groin over the common femoral artery. They will make another cut to free up the popliteal artery, usually on the inner side of the lower part of your leg.
Your surgeon will stitch a bypass graft onto the common femoral artery and then onto an artery in the lower part of your leg. Blood will then be able to flow through the graft, bypassing the blocked artery (see figure 1).
What complications can happen?
1 General complications of any operation
Pain
Bleeding
Infection of the surgical site (wound)
Unsightly scarring
Blood clots
2 Specific complications of this operation
Graft failure
Infection at the bypass graft join
Swelling of the leg
Blocking of one of the smaller arteries to the foot
Amputation
Fluid collecting
Nerve injury
Death
How soon will I recover?
You should be able to go home after about five to seven days.
Your surgeon will tell you when you can return to work depending on the extent of surgery and your type of work.
Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, you should ask a member of the healthcare team or your GP for advice.
Most people can return to normal activities. Your surgeon will advise you to have treatment with blood-thinning medication to make the graft last longer.
Summary
Narrowing of the arteries in the legs is a common condition caused by atherosclerosis. You may benefit from surgery if you have severe disease, and non-surgical treatment has failed to improve the blood supply to your legs.
NHS Direct on 0845 46 47 (0845 606 46 47 – textphone)
Acknowledgements
Author: Mr Bruce Braithwaite MChir FRCS
Paying for your procedure
Femoro-popliteal bypass surgery costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own procedure the cost will be explained and confirmed in writing when you book the procedure. Ask the hospital for a quote beforehand, and ensure that this includes the surgeon’s fee, the anaesthetist’s fee and the hospital charge for your procedure.
