Femoral-Tibial Bypass Surgery

Femoral-Tibial Bypass Surgery

Surgery Overview

Femoral-tibial bypass is a type of surgery. It redirects blood around blocked blood vessels in your lower leg or foot. It is often done if you have pain. Or it may be done if you have foot sores caused by circulation problems.

Your doctor will use something called a graft to make the blood go around (bypass) the blocked part of your blood vessel. Often the graft is a vein taken from another place in your leg. But sometimes it is a man-made blood vessel. The graft will carry blood from the femoral artery in your groin to the tibial artery in your lower leg or foot.

You will be asleep during the surgery. Or you will get medicine to numb your lower body and prevent pain. The doctor will make cuts in your skin above and below the blocked blood vessel. These cuts are called incisions. If one of your veins is being used for the graft, the doctor will make another incision in your leg to take out the vein.

Then the doctor will attach one end of the graft to the femoral artery and the other end to the tibial artery. After the graft is in place and blood is flowing through it, the doctor will use stitches or staples to close the incisions. You will have scars, but they will fade with time.

You may need to stay in the hospital for 3 to 5 days. It may take 6 to 12 weeks to fully recover.

How It Is Done

Blocked artery and position of graft in femoral-tibial bypass surgery

A femoral-tibial bypass is used to bypass a narrowed or blocked artery in the leg. The bypass restores blood flow to the lower leg and foot.

To bypass a narrowed or blocked artery, blood is redirected through a graft. The graft is either a healthy blood vessel that has been transplanted or a man-made material. This graft is sewn above and below the diseased artery so that blood flows through the graft and around the diseased part.

In this picture, a graft bypasses the blockage in an artery near the knee. The graft connects the common femoral artery near the hip to a tibial artery in the lower leg.

What To Expect

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. This usually gets better after about 1 week. You can expect your leg to be swollen at first. This is a normal part of recovery. 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. It depends on the type of work you do and how you feel.

You will have regular tests to check for problems with the graft.

Why It Is Done

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. Usually, a person has severe symptoms or the problem is limb-threatening before bypass surgery is considered.footnote 1, footnote 2

Learn more

How Well It Works

Bypass surgery can restore blood flow and relieve intermittent claudication.footnote 1, footnote 2

Risks

All surgeries carry a certain amount of risk. These risks include:

  • Infection from the incision.
  • Bleeding.
  • Heart attack or stroke.

Specific risks for this bypass surgery include:

  • Leg swelling.
  • Failed or blocked grafts.

References

Citations

  1. 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.
  2. Conte M, 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.

Credits

Current as of: April 29, 2021

Author: Healthwise Staff
Medical Review:
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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