Vascular conditions, including peripheral artery disease and critical limb ischemia, can affect blood flow to your lower limbs or abdominal area. Bypass is a procedure to reroute blood flow around blocked arteries. It uses a segment of a healthy vein from your arm or leg or a human-made (synthetic) alternative.
Vascular disease, particularly arterial blockages, can lead to poor blood flow. As a result, you can develop limb pain and wounds. Bypass procedures reroute blood flow around a blocked artery segment with a graft.
A graft may be a vein from your body or a synthetic material. Providers use synthetic material when they’re unable to use the veins from your body as the graft. The procedure restores blood flow to keep limb tissue alive so you can avoid amputation.
There are various types. They’re named according to the artery being bypassed and the arteries receiving the rerouted blood. Some of the most common bypass procedures include:
Vascular bypass is for people with severe blockages in the arteries to their lower extremities, including the abdominal aorta. Severe artery blockages are also known as critical limb ischemia, which results from peripheral artery disease (PAD).
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Yes. There are various tests that can help assess your vascular disease, determine which arteries need treatment and plan your bypass procedure. These tests may include ankle-brachial index and vascular ultrasound.
Your provider may perform other tests to check for vascular disease in your heart before proceeding with your vascular bypass procedure. Often, people who have vascular disease in their limbs also have vascular disease in their hearts.
You’ll have your procedure in the hospital. Here’s what to expect:
The procedure generally takes two to six hours depending on the type of bypass performed.
Healthcare providers often use the saphenous vein, which is just below the skin’s surface in your leg. Other options include arm veins such as the cephalic vein. If your provider needs a larger vein, they may use the femoral vein in your thigh.
If your surgeon can’t use your veins for the bypass graft, then they’ll use a synthetic material instead. Synthetic grafts work well for larger arteries, while your own vein is best for smaller vessel bypasses.
Complications can occur during the procedure, during your recovery or years later. People with other medical issues, such as heart disease, kidney failure and/or diabetes, are more likely to experience these issues.
You can expect to stay in the hospital for a few days. You may also be on medications that thin your blood (anticoagulants) to prevent blood clots in the graft.
Your provider will expect you to get out of bed and walk around — both in the hospital and at home after surgery. You may need extra help to do so. Some people need physical and/or occupational therapy after the procedure. You’ll be able to gradually return to your daily activities.
Limb salvage rates are high with successful bypass graft procedures. However, the procedure doesn’t cure peripheral artery disease (PAD). The grafts can narrow or block up over time.
Grafts are much more likely to fail when people use tobacco, including cigarette smoking. It’s important that you continue to follow up with your vascular surgeon to monitor your bypass.
Contact your healthcare provider if you’re experiencing leg issues, such as:
You should also reach out for help if there are other signs of complications, such as:
A note from Cleveland Clinic
If you have a diseased or blocked artery to your leg, your healthcare provider might recommend a vascular bypass. This procedure reroutes blood flow around blocked arteries. Most people have good outcomes and high rates of limb salvage, but you need ongoing care to monitor your bypass and manage your vascular disease.
Last reviewed by a Cleveland Clinic medical professional on 10/20/2022.
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