Femoral-tibial bypass surgery (also known as
infra-popliteal reconstruction) is used to bypass diseased blood vessels in the
lower leg or foot.
To bypass the narrowed or blocked blood vessel, blood is
redirected through a healthy blood vessel that has been transplanted or through
a man-made graft material. This vessel or graft is sewn above and below the
diseased artery so that blood flows through the new vessel or graft. Before
surgery, the doctor determines what type of material is best suited to bypass
the blood vessel.
Whenever possible, the surgeon will choose to
use an existing piece of vein taken from either leg. Man-made graft materials
(such as polytetrafluoroethylene [PTFE] or Dacron) are more likely to become
narrowed again. But they may still be effective and are used when a vein is not
The section of vein or man-made blood vessel is sewn
onto the small vessels of the lower leg or foot so that blood can travel
through the new graft vessel and around the diseased area.
or an injection in the spine (epidural) is used for this surgery. General
anesthesia will cause you to sleep through the procedure. An epidural prevents
pain in the lower part of the body.
You may need
to stay in the hospital for 3 to 5 days.
You will have some pain from the cuts (incisions) the doctor made. The pain usually gets better after about 1 week. Your doctor will give you pain medicine. You can expect your leg to be swollen at first. This is a normal part of recovery and may last 2 or 3 months.
You will need to take it easy for 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. It depends on the type of work you do and how you feel.
You will need to have regular checkups with your doctor to make sure the graft is working.
This surgery is used for people who
have narrowed or blocked tibial or peroneal arteries, which are near the
surface of the legs. Most of the time, people also have narrowed or blocked femoral and
popliteal arteries too. Usually, a person has severe symptoms
or the problem is limb-threatening before bypass surgery is considered.footnote 1, footnote 2
Bypass surgery can restore blood flow and relieve intermittent claudication.footnote 1, footnote 2
All surgeries carry a certain amount of risk. These risks include:
Specific risks for this bypass surgery include:
Your doctor may recommend that you try an exercise program and medicine before he or she recommends that you have this surgery.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
CitationsGerhard-Herman MD, et al. (2016). 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease. Circulation, published online November 13, 2016. DOI: 10.1161/CIR.0000000000000471. Accessed November 25, 2016.Conte MS, et al. (2015). Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: Management of asymptomatic disease and claudication. Journal of Vascular Surgery, 61(3S): 2S-41S. DOI: 10.1016/j.jvs.2014.12.009. Accessed November 25, 2016.Other Works ConsultedConte MS, et al. (2015). Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: Management of asymptomatic disease and claudication. Journal of Vascular Surgery, 61(3S): 2S-41S. DOI: 10.1016/j.jvs.2014.12.009. Accessed November 25, 2016.Gerhard-Herman MD, et al. (2016). 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease. Circulation, published online November 13, 2016. DOI: 10.1161/CIR.0000000000000471. Accessed November 25, 2016.
ByHealthwise StaffPrimary Medical ReviewerRakesh K. Pai, MD, FACC - Cardiology, ElectrophysiologyMartin J. Gabica, MD - Family MedicineAdam Husney, MD - Family MedicineE. Gregory Thompson, MD - Internal MedicineSpecialist Medical ReviewerDavid A. Szalay, MD - Vascular Surgery
Current as ofApril 24, 2017
Current as of:
April 24, 2017
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology & Martin J. Gabica, MD - Family Medicine & Adam Husney, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & David A. Szalay, MD - Vascular Surgery
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Last modified on: 8 September 2017