Are you a candidate for bypass surgery?
Candidates for leg bypass surgery include those with symptoms of atherosclerosis, claudication, gangrene in the leg from diabetes.
What happens during bypass surgery?
Step-by-step description of how the surgeon performs the bypass procedure.
After bypass surgery
Hospitalization, rehabilitation, returning home, and when to contact the doctor.
Why choose NYU for bypass surgery?
Benefits and risks of bypass surgery, NYU surgeons experience and qualifications.
Bypass Surgeons at NYU
List of NYU vascular surgeons who specialize in bypass surgery
Are you a candidate for bypass surgery?
Even if you are not a candidate for angioplasty and stenting, you may be a candidate for bypass surgery.
You may be a candidate if you:
- have symptoms of atherosclerosis (hardening of the arteries), including claudication (pain when walking) due to a lack of blood flow to the legs
- have developed diabetic foot, or gangrene (tissue death) in your leg from diabetes or atherosclerosis
- are experiencing mesenteric ischemia (severe abdominal pain from decreased blood flow to the intestines)
- have leg ulcers (non-healing skin wounds on the lower leg, foot, or toes)
- have a pulmonary embolism (clot in the lung resulting from deep vein thrombosis
- have developed a renovascular condition (decreased circulation to the kidneys causing kidney failure or high blood pressure.
- have carotid artery disease (plaque buildup causing narrowing of the carotid artery in the neck)
More information about bypass surgery is available on the Society for Vascular Surgery website.
What happens during bypass surgery?
Once the diagnosis of atherosclerosis, carotid artery disease, diabetic foot, a renovascular condition, pulmonary embolism, mesenteric ischemia, or leg ulcer has been made, your surgeon may recommend bypass surgery.
During leg bypass surgery, the surgeon creates a new route for blood to travel around an artery blocked by atherosclerosis, restoring blood flow to the leg.
Bypass Procedure
Your physician will usually require that you stop taking any medications that may cause bleeding or complications during the procedure, and that you not eat or drink anything for 8 hours before the surgery.
- Depending on your symptoms, your health, and the amount of plaque built up in your arteries, a local or general anesthetic is administered and surgery begins.
- The surgeon makes an incision in your skin, selects and removes a vein to serve as a bypass graft for your artery.
- The surgeon makes another incision in your skin near the blocked portion of your artery and evaluates the pulse in the healthy part of your artery to ensure that the blood flow is sufficient to supply the bypass.
- The surgeon opens the artery below the blockage and connects one end of the vein graft with permanent stitches.
- The surgeon directs the vein graft to a location above the blockage, opens the artery, and connects the other end of the graft with permanent stitches.
- The surgeon checks the bypass for correct alignment and potential leakage.
- The surgeon closes all of the incisions and orders a duplex scan (ultrasound exam to evaluate blood flow in the artery) or other noninvasive test to ensure that the bypass is functioning properly.
After surgery, patients generally stay in the hospital 3–10 days.
After bypass surgery
Patients typically stay in the hospital 3–10 days following the procedure. Stitches are removed from the skin incisions 7–14 days after surgery.
What happens in the hospital? Do patients have any sort of rehabilitative services?
Your surgeon may prescribe an antiplatelet medication to prevent blood clots around the bypass site.
Some patients require help from a visiting nurse, home health aide, or physical therapist when they first return home.
Contact your physician immediately if you develop:
- fever
- coldness or pain in your leg (if you have had leg bypass surgery)
- redness, swelling, or drainage in your incision area
Why choose NYU for bypass surgery?
Arguably the greatest benefit of bypass surgery is limb salvage, or preserving a leg that would otherwise need to be amputated due to gangrene (tissue death).
Relieving the pressure on an arterial blockage also reduces a patient’s chance of stroke, irreversible brain damage, and death of organs.
Risks of Bypass Surgery
While no surgical procedure is risk free, complications from bypass surgery are unusual. Selecting a vascular surgeon who is well trained and experienced in your type of bypass surgery greatly reduces your risk of complication.
Vascular specialists at NYU take a team approach that maximizes decades of experience, in-depth knowledge of the latest research and treatment techniques, and outstanding surgical outcomes including limb salvage in 70–80% of patients scheduled for amputation elsewhere.
Complications from bypass surgery range in severity.
Less serious complications include swelling or inflammation at the incision site.
More serious complications include:
- blockage of the bypass
- bleeding from the incision
- infection
- High blood pressure
- Obesity
- High cholesterol
- Coronary artery disease
- Chronic obstructive pulmonary disease, such as emphysema
- Poor kidney function
- Diabetes
- Smoking
