Our Summary

This study looked at the effectiveness of redoing a certain type of surgery, specifically lower leg bypass operations. These procedures are often used to restore blood flow in the leg when it has been blocked, but sometimes they fail and need to be redone. The researchers wanted to see how often these reoperations were successful, particularly when the surgeon used a patient’s own vein to do the bypass.

They looked at the cases of 100 patients who had this kind of reoperation between 2006 and 2016, and found that most of these patients had already had one or more bypass operations before. The researchers used the patient’s own veins for the bypass in almost all of the reoperations.

The main goal of the reoperations was to avoid having to amputate the patient’s leg. They found that, on average, patients who had only had one previous bypass operation were able to avoid amputation for about 775 days after the reoperation. However, patients who had had two or more bypasses before were only able to avoid amputation for about 263 days on average.

In conclusion, they found that these kinds of reoperations can be effective in avoiding amputation, especially when the surgeon uses the patient’s own veins for the bypass. However, patients with more serious disease in their leg were harder to save.

FAQs

  1. What is the purpose of femoral-popliteal bypass reoperations?
  2. How successful are reoperations in preventing the need for amputation, according to the study?
  3. Does the number of previous bypass procedures affect the success rate of reoperations?

Doctor’s Tip

A helpful tip a doctor might tell a patient about femoral-popliteal bypass is to make sure to follow all post-operative care instructions carefully, including taking prescribed medications, keeping the incision site clean and dry, and attending follow-up appointments. It is also important to maintain a healthy lifestyle, including regular exercise and a balanced diet, to help promote healing and prevent further complications. If any concerning symptoms or changes occur, such as increased pain, swelling, or changes in skin color, it is important to contact your healthcare provider immediately.

Suitable For

Patients who are typically recommended for femoral-popliteal bypass surgery are those with peripheral artery disease (PAD) or other conditions that cause blockages in the arteries of the leg. These patients may experience symptoms such as pain, numbness, or weakness in the leg, and may be at risk for complications such as gangrene or amputation if blood flow is not restored.

Patients who have already undergone one or more bypass surgeries and are experiencing a recurrence of symptoms or blockages may also be recommended for a femoral-popliteal bypass reoperation. This type of surgery is often considered when other treatments, such as medication or angioplasty, have not been successful in restoring blood flow to the affected leg.

Overall, patients who are recommended for femoral-popliteal bypass surgery are those who are at risk for severe complications due to reduced blood flow in the leg, and who have not responded well to other treatment options. These patients may benefit from the improved blood flow and potential avoidance of amputation that can be achieved through a successful bypass surgery.

Timeline

  • Before femoral-popliteal bypass: The patient may have experienced symptoms such as leg pain, numbness, or weakness due to blocked blood flow in the leg. They would have undergone diagnostic tests such as angiography to determine the extent of the blockage. The decision to undergo femoral-popliteal bypass surgery would have been made based on the severity of the blockage and the patient’s overall health.

  • During femoral-popliteal bypass: The patient would have undergone general anesthesia and the surgeon would have made an incision in the leg to access the blocked artery. The surgeon would then use a healthy vein from another part of the body or a synthetic graft to create a new pathway for blood to flow around the blockage. The surgery typically takes several hours to complete.

  • After femoral-popliteal bypass: The patient would have been monitored in the hospital for a few days to ensure that the surgery was successful and that the blood flow in the leg has improved. They would have been given instructions on how to care for the incision site, manage pain, and prevent complications such as infection. Physical therapy may have been recommended to help the patient regain strength and mobility in the affected leg. Follow-up appointments would have been scheduled to monitor the long-term success of the surgery and address any issues that may arise.

What to Ask Your Doctor

  1. What is the success rate of femoral-popliteal bypass surgery for restoring blood flow in the leg?
  2. How many previous bypass operations have I had, and how does that affect the success of a reoperation?
  3. Will my own vein be used for the bypass, and does that impact the effectiveness of the surgery?
  4. What is the likelihood of avoiding amputation after a reoperation, and how long can I expect to avoid it?
  5. What are the potential risks and complications associated with femoral-popliteal bypass surgery and reoperations?
  6. How long is the recovery process after a reoperation, and what kind of follow-up care will I need?
  7. Are there any alternative treatment options to consider for restoring blood flow in my leg?
  8. How often will I need to follow up with you after the surgery, and what signs or symptoms should I watch out for that may indicate a complication?

Reference

Authors: Fraser CD 3rd, Kovler ML, Liu RH, Beaulieu RJ, Reifsnyder T. Journal: Ann Vasc Surg. 2020 Jul;66:537-542. doi: 10.1016/j.avsg.2019.10.070. Epub 2019 Oct 31. PMID: 31678127