What is peripheral vascular bypass surgery?

Peripheral vascular bypass surgery is surgery to improve blood flow when one or more of the arteries that supplies blood to a leg or arm is narrowed or blocked. A blood vessel from another part of your body or a man-made (synthetic) blood vessel, called a graft, will be used to make a detour for blood to flow through. One end of the graft will be stitched above the blockage in the artery. The other end will be stitched below the blockage. This will allow blood to bypass the blockage and provide oxygen-rich blood to the rest of the leg or arm.

How is peripheral vascular bypass surgery done?

Before the procedure:

• Your healthcare provider will ask you to sign a consent form for peripheral vascular bypass surgery. The consent form will state the reason you are having the procedure, what happens during the procedure, and what you may expect afterward.
• Tell your healthcare provider if you are allergic to any medicines.
• Tell your healthcare provider if you are taking any medicines, including nonprescription drugs, herbal remedies, or illegal drugs (if any).
• You will have a needle (IV) inserted into a vein in your hand or arm. This will allow medicine to be given directly into your blood and to give you fluids, if needed.

During the procedure:

• You may be given a sedative through your IV to help you to relax.
• You will be given medicine called anesthesia to keep you from feeling pain during the procedure. You may have:
  • Local anesthesia, which numbs the area where the surgery will be done.
  • Regional anesthesia, which numbs a larger area of your body.
  • General anesthesia, which relaxes your muscles and you will be asleep. A breathing tube is usually put in your throat when you have general anesthesia.
• You may have a small tube (catheter) placed into your bladder through the urethra (the opening from the bladder to the outside of the body) to drain and measure urine from the bladder.
• The surgeon will make a cut in the skin above the blood vessel that is blocked.
• The graft blood vessel ends will be sewn into the areas above and below the blockage.
• The cut in your skin will be closed with stitches.

After the procedure:

• You will be checked often by nursing staff.
• There will be a dressing on the surgery site. The dressing will be checked and changed by your provider or the nursing staff as needed.
• Your provider may prescribe medicine to:
  • Treat pain
  • Treat or prevent an infection
  • Help prevent blood clots
  • Slow the heart rate and reduce the workload of the heart
  • Relax and widen blood vessels and allow blood to flow through them easier
  • Control cholesterol levels
  • Reduce fluid build-up and swelling in the body
• Your blood oxygen level may be monitored by a sensor that is attached to your finger or earlobe.
• A cardiac (heart) monitor may be used to keep track of your heartbeat.

What can I do to help?

• You will need to tell your healthcare team if you have new or worsening:
  • Chest pain or pressure, squeezing, or fullness in the center of your chest that lasts more than a few minutes, or goes away and comes back (may feel like indigestion or heartburn)
  • Pain or discomfort in one or both arms or shoulders, or in your back, neck, jaw, or stomach
  • Trouble breathing
  • Breaking out in a cold sweat for no known reason
  • Along with the previous symptoms: feeling very tired, faint, or sick to your stomach.
  • Bluish color of the skin of the arm or leg below the surgery
  • Feeling like your heart is beating too fast, too slow, or skipping beats
  • Numbness in your feet or hands
  • Signs of infection around your surgical wound. These include:
    • The area around your wound is more red or painful
    • The wound area is very warm to touch
    • You have blood, pus, or other fluid coming from your wound area
    • You have chills or muscle aches
  • Warmth, redness, swelling, or pain in your leg, ankles, or feet
  • Weakness, numbness, tingling or pain in your face, arm, or leg, especially on one side of your body
• Ask questions about any medicine, treatment, or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many factors. The average amount of time to stay in the hospital after peripheral vascular bypass surgery is 5 to 7 days.