A surgical bypass reroutes blood flow around a blocked vein by creating a new pathway for blood flow using a graft.
In healthy veins, there is continuous flow of blood from the limbs back toward the heart. Venous insufficiency can occur when forward flow through the veins is obstructed, as in the case of a blood clot. In some patients who have a blood clot, the clot dissolves over time and causes no problems.
In some people, however, scar tissue forms at the site of the clot and causes a blockage in the vein preventing blood flow through it. In some instances, surgery is necessary to bypass this blockage. Surgery is typically reserved for patients who have severe venous insufficiency demonstrated by a painful swollen leg with ulcerations or wounds.
Each patient is evaluated, and treatment will be individualized for the patient’s circumstances.
A surgical bypass is performed in the hospital setting by a vascular surgeon.
To find out if you are a candidate for this procedure, please call the Vascular Surgery Department at 216.444.4508 or 800.223.2273 ext. 4-4508.
A few days before the procedure, pre-procedure tests may be performed to ensure that it is safe to perform the surgery. You may need to discontinue certain medications before the procedure. Your health care team will provide specific instructions to help you prepare for the procedure.
The surgical bypass will be performed under general anesthesia. To bypass the blockage, the surgeon makes a small opening above and below the blockage in the diseased vein and connects a graft, which is a portion of a normal vein taken from another site in the body, to these openings. This reroutes the blood through the bypass around the blockage.
The procedure itself generally takes three to five hours, but the preparation and recovery time add several hours. The surgery may require a minimum hospital stay of four to seven days.
Some patients require admission to an intensive care unit for close monitoring for about one to two days after the surgery, but this is not routine. Once the patient is transferred to the nursing unit, the hospital stay is about three to seven more days. Most patients will receive physical therapy during the recovery period. Most patients will require anticoagulation in the post-operative period, and many will require long-term anticoagulation with medications such as Coumadin. The exact duration of anticoagulation therapy is patient specific and will be determined by your surgeon.
Your doctor will provide specific guidelines for your recovery.
Your doctor will discuss the specific risks and potential benefits of the recommended procedure with you.
Bypass surgery usually has no complications, but there may be a risk of injury to the blood vessel, leg swelling, bleeding or wound complications. Your vascular surgeon will discuss the important risks and benefits with you.
Special precautions are taken to decrease these risks, and there may be other possible risks. When you meet with your doctor, please ask questions to make sure you understand the risks of the procedure and why the procedure is recommended.
As with any surgical procedure, you will feel somewhat tired for a few weeks. You will have mild pain along the incisions, and you may experience mild leg swelling.
Restoring blood flow by performing a surgical bypass usually provides good relief of symptoms in the right patients. Venous bypass is typically reserved for patients with severe venous disease, and many patients have significant improvement in their symptoms. Your doctor will discuss the results of the procedure with you.
Doctors vary in quality due to differences in training and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality become and the more they matter.
Clearly, the doctor and hospital that you choose for complex, specialized medical care will have a direct impact on how well you do. To help you make this choice, please review our Miller Family Heart and Vascular Institute Outcomes.
Choosing a doctor to treat your vascular disease depends on where you are in your diagnosis and treatment. The following Heart and Vascular Institute Sections and Departments treat patients with all types of vascular disease, including blood clotting disorders:
Section of Vascular Medicine: for evaluation, medical management or interventional procedures to treat vascular disease. In addition, the Non-Invasive Laboratory includes state-of-the art computerized imaging equipment to assist in diagnosing vascular disease, without added discomfort to the patient. Call Vascular Medicine Appointments, toll-free 800-223-2273, extension 44420 or request an appointment online.
Department of Vascular Surgery: surgery evaluation for surgical treatment of vascular disease, including aorta, peripheral artery, and venous disease. Call Vascular Surgery Appointments, toll-free 800-223-2273, extension 44508 or request an appointment online.
IVC Filter Retrieval Clinic - to make an appointment, call Vascular Medicine at 216.444.4420. Ask for Dr. Bartholomew in the Filter Retrieval Clinic. Your appointment will include a consultation with Dr. Bartholomew and the physicians who will perform the IVC filter retrieval procedure.
You may also use our MyConsult second opinion consultation using the Internet.
The Heart and Vascular Institute also has specialized centers and clinics to treat certain populations of patients:
Learn more about experts who specialize in the diagnosis and treatment of vascular and arterial disease.
If you need more information, click here to contact us, chat online with a nurse or call the Miller Family Heart and Vascular Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.
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Last reviewed by a Cleveland Clinic medical professional on 05/10/2019.