Surgical bypass is a procedure that restores blood flow to a blocked artery by creating a detour around the blockage. A surgeon connects a graft to the artery above and below the blockage, creating a new path for blood to flow. The graft is made of either a portion of one of your veins or from a synthetic man-made material.

Bypass surgery is often associated with heart arteries. Vascular surgeons also use bypasses to treat peripheral artery disease, also called peripheral vascular disease. Peripheral artery disease occurs most often in arteries in the legs and is caused by atherosclerosis, a buildup of fatty deposits on artery walls. As the artery narrows, blood flow is reduced, the arteries harden and blockages or blood clots can develop. Your physician may recommend bypass surgery to restore blood flow to a blocked peripheral artery and the affected area of the body.

Bypass surgery will reduce the symptoms of peripheral artery disease but it does not remove the blockage or prevent the disease from progressing.

Surgical bypass candidates

In many cases, lifestyle and diet changes and exercise are enough to reduce the symptoms of peripheral artery disease. Your physician may recommend an angioplasty or a stent, minimally invasive treatments that restore blood flow.

If you are experiencing severe symptoms of peripheral artery disease and less invasive treatment alternatives are not possible or have not improved your condition, your physician may recommend bypass surgery. Symptoms that may occur when walking or climbing stairs are heaviness, aching or numbness in the legs or feet. Symptoms often stop when at rest. Signs of more severe peripheral artery disease may include:

• Leg pain that does not go away when at rest
• Sores or wounds on the feet or toes that heal slowly or not at all
• Gangrene
• A marked decrease in temperature of the lower leg or foot compared to the other leg or the rest of the body

Why choose Ohio State for surgical bypass?

Since The Ohio State University Wexner Medical Center is an academic medical center, our patients benefit from innovative research, a depth of medical expertise and the newest technologies and treatment techniques available.

Surgeons at Ohio State use various tools and techniques to ensure you are as safe and comfortable as possible.

What to expect during surgical bypass

Preparing for your procedure

Before your bypass surgery, you meet with your physician to discuss your medical history, the medications you take and any questions you have.

Tests before your procedure may include:

• Doppler ultrasound – A non-invasive diagnostic test that uses high-frequency sound waves to determine the speed and direction of blood flow
• MRA (magnetic resonance angiography) – A noninvasive imaging procedure that uses large magnets, radiofrequencies and a computer to evaluate blood flow through arteries
• CT angiogram (also called angiography or a CT coronary angiogram) – A noninvasive procedure that uses sophisticated imaging technology with the injection of dye from an IV

Your physician may also order segmental blood pressures or pulse volume recordings to determine the narrowing of the arteries in the affected area. If you have had a heart attack or chest pain in the past, your physician may recommend a nuclear stress test or a catheterization.

During your procedure

You will receive either a general anesthesia, which means you are asleep during the procedure, or a regional anesthesia, which numbs a specific area of the body.

Your surgeon selects and removes a vein from another part of your body that will be used as the bypass graft. To reach the bypass site your surgeon makes an incision in the skin over the blocked artery. The vein or synthetic graft is connected above and below the blockage. Your surgeon may perform a Doppler ultrasound or angiogram at the end of the procedure to check the bypass for any problems.

After your procedure

Typically your hospital stay after surgery is three to five days. Your surgeon will remove staples or stitches from your incisions after you leave the hospital, usually three to four weeks after your surgery. Your physician may recommend you take an antiplatelet medication, such as aspirin, to help prevent blood clots.

Contact your physician immediately if you develop problems or signs of infection. Signs of infection may include:

• Fever
• Cold, painful arm or leg
• Swelling and redness at incision site
• Drainage from the incision