Femorofemoral (femoral-femoral) bypass is a method of surgical revascularization used in the setting of unilateral common and/or external iliac artery occlusive disease.
The iliac artery is responsible for blood supply to the legs. Some people develop narrowing or blockage of the iliac arteries. When this happens, the leg muscles gradually develop symptoms of pain. The pain worsens when exercising and it may eventually become so severe that it occurs at night and may even progress to gangrene. When only one iliac is blocked, it is possible to join the femoral artery at the top of the thigh and the femoral artery from the good side (that is, the leg that has better blood circulation) using a graft. This means, the blood in the bad leg travels down the iliac artery of the good side, crosses over under the skin of the lower abdominal wall, and then flow into the artery on the bad side.
Femorofemoral bypass surgery
Two cuts are made, either one in each groin or one in the groin and the other in the lower part of the tummy. An artificial graft is inserted to carry blood from the main artery going to the good leg, to the main artery in the bad leg, thereby bypassing the blocked artery. The artery going into the good leg will, therefore, supply both legs with blood. The cuts are then closed with either stitch that dissolve by themselves, or with stitches/clips that will later be removed.
The aftermath of a femorofemoral bypass surgery
After the femorofemoral bypass surgery, patients are transferred to the recovery room where they are monitored until they are awake.
Fluids are supplied intravenously until patients feel well enough to sit up and take fluids and food by mouth. Within the first two days the epidural, drip, and bladder catheter will be removed. Gradually patients become more mobile until they are fit enough to go home. The hospital stay lasts for 4 to 5 days.
Indications for femorofemoral bypass are as follows: Symptomatic lower-extremity ischemia (disabling claudication, rest pain, tissue loss) due to acute or chronic occlusion of a unilateral iliac artery system.. Unavailability of endovascular options for management of iliac occlusive disease.
What are the benefits of a femorofemoral bypass surgery?
A femorofemoral bypass surgery allows walking without pain.
Are there any complications associated with a femorofemoral bypass surgery?
There are a couple of complications that may result from a femorofemoral bypass surgery.
- Bypass blockage: The main likely complication of a femorofemoral bypass surgery is blood clot within the bypass which leads to blockage.
- Graft infection: In very rare instances, the artificial graft may become infected. This is a very serious complication and its treatment involves removal of the graft.
How can I prepare for a femorofemoral bypass surgery?
A femorofemoral bypass surgery requires fasting for six hours prior to the surgery. That is, no eating or drinking anything (except water) for six hours before surgery. Food or liquid in the stomach during a femorofemoral bypass surgery could come up to the back of the throat and damage the lungs.
Is a femorofemoral bypass procedure painful?
A femorofemoral bypass procedure is done under general anaesthetic (while asleep) or an epidural (a small tube placed at the back through which medication is delivered to numb the legs).
What are self-care tips?
- Quit smoking
- Carry out gentle exercises. Like walking and cycling.
- Regularly check your blood pressure, at least every six months.
- Control your blood sugar levels if you are diabetic.
- Eat a healthy balanced diet and try to reduce excessive weight.