Aortobifemoral bypass for peripheral arterial disease
Aortobifemoral bypass surgery is used to bypass diseased large blood vessels in the abdomen and groin.
To bypass the blocked blood vessel, blood is redirected through a graft made of synthetic material (such as polytetrafluoroethyline [PTFE] or Dacron). This graft is sewn above and below the diseased artery so that blood flows through the graft. These man-made grafts are more likely to be used than transplanted natural grafts for aortobifemoral surgery, because the blood vessels involved are large.
The artificial blood vessel is formed into a Y shape. The single end of the Y is sewn on the aorta. The two split ends of the Y are sewn below the blocked or narrowed areas of the femoral arteries. This allows the blood to travel around (bypass) the diseased areas. See a picture of aortobifemoral bypass.
General anesthesia is used and will cause you to sleep through the procedure.
What To Expect After Surgery
Because this surgery is done on large, deep blood vessels inside the abdomen, recovery times are longer than for bypass surgery to treat diseased blood vessels in the legs.
You will need to spend 24 to 48 hours in bed after the surgery and will be in the hospital for 4 to 7 days.
Why It Is Done
Aortobifemoral bypass surgery is for people who have blocked blood vessels (aorta or iliac arteries) in the abdomen and pelvis. The blockage usually must be causing significant symptoms or be limb-threatening before bypass surgery is considered.
How Well It Works
Aortobifemoral bypass grafts stay open about 90% of the time for at least 5 years.1
Risks for aortobifemoral bypass procedure include:
- Failed or blocked grafts.
- Heart attack.
- Sexual dysfunction caused by nerve damage in the pelvis.
What To Think About
Bypass surgery is preferred for people who have many areas of blockage or a long, continuous blockage in the arteries of the abdomen and/or the pelvis.
Angioplasty may be preferred for people who have a small number of short, narrowed areas in the arteries of the leg or pelvis.
- Hirsch AT, et al. (2006). ACC/AHA 2005 practice guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): A collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation, 113(11): e463–e654.
Last Updated: October 16, 2009