Other possible complications soon after surgery include: Heart attack, as many patients with PAD also have heart disease. Wound infections, though antibiotics are given before and after surgery to help prevent this. Bladder or other infections. How to Prepare. When you agree to surgery If you smoke, stop as soon as possible to lessen the chance of many of the complications. You may need blood tests, an EKG, special x-rays or a heart stress test. Days before Follow your normal routine and get plenty of sleep.
Carefully follow instructions about medications the day before and day of surgery. You may need to fast no food or drink beginning at midnight the day of surgery. You will be in the hospital for days for monitoring and recuperation, perhaps 7 days if you had an aortic bypass. The bowels often go to sleep for several days, so food is re-introduced gradually.
Typically, there is swelling and sometimes drainage. Sometimes, patients will go to a rehab facility for a few days after leaving the hospital to regain strength. The other end is connected to the popliteal artery above or below your knee. After the graft is in place and the blood is flowing through it, the doctor will close the incisions with stitches or staples.
You will probably stay 2 to 4 days in the hospital. You will have some pain from the incisions. This usually gets better after about 1 week. Your leg may be swollen at first. This is normal. It may last 2 or 3 months. You will need to take it easy for at least 2 to 6 weeks at home.
It may take 6 to 12 weeks to fully recover. You will probably need to take at least 2 to 6 weeks off from work. The surgeon will determine whether to use a man-made graft or a vein from the leg to bypass the diseased artery. Once the surgeon has attached the graft onto the diseased artery, a type of X-ray called an arteriogram may be done to make sure that blood flow has been restored to the leg through the new bypass graft.
You may get blood pressure medicine through your IV during and after the procedure to keep your blood pressure within a certain range. An intravenous IV line will be started in your hand or arm before the procedure to inject medicine and to give IV fluids, if needed. You will be connected to a heart monitor that monitors the electrical activity of the heart during the procedure. Your provider will monitor your heart rate, blood pressure, breathing rate, and oxygen level during the procedure.
You will get medicine in your IV before the procedure to help you relax. You will likely stay awake, but feel sleepy, during the procedure. Your provider will check your pulses below the insertion site before and after the procedure. Your provider will inject a local anesthetic into the skin at the insertion site.
You may feel some stinging at the site for a few seconds after the local anesthetic is injected. Once the local anesthetic has taken effect, your provider will insert a sheath, or introducer, into the blood vessel. The catheter will be inserted into the femoral artery through this plastic tube. Your provider will put a special catheter or guide wire into the femoral artery and move it to the site of the blockage using X-ray guidance.
The position of the catheter may be confirmed by injecting a small amount of contrast dye into the artery, which may then be seen on a monitor. The provider will insert an angioplasty catheter and advance it to the location of the blockage. He or she will inflate a balloon at the tip of the catheter. This opens the artery. The provider may inflate and deflate the balloon several times to open the artery.
In some cases, he or she may insert a tiny, expandable metal mesh coil stent to help keep the artery from narrowing or closing again. Once it has been determined that the artery is opened, the angioplasty catheter will be removed. Your provider may close the insertion site with a device that uses collagen to seal the opening in the artery, or with sutures.
Your provider will determine which method is best for you. After the procedure, you will be taken to the recovery room and watched. Once your blood pressure, pulse, and breathing are stable and you are alert, you may be taken to the intensive care unit ICU or your hospital room.
Your healthcare provider will check your pulses below the surgical site often to check blood flow to the limb. He or she will also watch your leg for color pale or pink , warmth, sensations of pain, and movement. The incision may be tender or sore for several days after the procedure.
Take a pain reliever as recommended by your doctor. You may be on special IV medicine to help your blood pressure and your heart, and to control any problems with bleeding. As you stabilize, your provider will gradually decrease, and then stop, these medicines. When your healthcare team determines that you are ready, you will be moved from the ICU to a postsurgical nursing unit.
Your recovery will continue. You can gradually increase your activity as you get out of bed and walk around for longer periods. After the procedure, you will be taken to the recovery room at watched. Tell your nurse right away if you feel any chest pain or tightness, or any other pain, as well as any feelings of warmth, bleeding, or pain at the insertion site.
The best way to determine if femoral popliteal bypass is right for you is to consult with your doctor. Learn more about popliteal bypass surgery and what to expect:. There are risks involved with any surgical procedure. Your doctor will explain the risks, as well as the quality of life improvements associated with femoral popliteal bypass, so that you can make the decision that is best for you.
It is important to address any questions, concerns, allergies or sensitivities to medications with your physician prior to surgery.
Femoral Popliteal Bypass Fem-Pop Bypass Our experts at Stanford perform popliteal bypass surgery to alleviate complications of claudication and peripheral vascular disease. Conditions Treated Procedures. Share on Facebook. Notice: Users may be experiencing issues with displaying some pages on stanfordhealthcare.
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