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Bypass Surgery for Venous Disease

What is a surgical bypass for venous disease?

A surgical bypass reroutes blood flow around a blocked vein by creating a new pathway for blood flow using a graft.

Why is this procedure performed? Why do I need this procedure?

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.

Where is the procedure performed and who performs this procedure?

A surgical bypass is performed in the hospital setting by a vascular surgeon.

What are the risks and potential complications of the procedure?

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.

How do I prepare for the procedure?

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.

What happens during 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.

How long does the procedure last?

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.

What happens after the procedure?

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.

Are there any side effects of the treatment?

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.

What are typical results of the procedure?

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.

How do I find out if I am a candidate for this procedure?

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.