Femoral popliteal bypass surgery

What is femoral popliteal bypass surgery?

Femoral popliteal bypass surgery, or fem pop bypass, creates a new route for blood flow to your lower leg. During the leg bypass, your surgeon places a graft, a replacement for the damaged artery. The graft may be a tiny synthetic (human-made) tube. Or it may be a section of another blood vessel — most often the saphenous vein from your inner thigh. You’ll have an ultrasound scan before surgery to determine the best approach for you.

The graft provides a pathway for blood to travel to your leg and into your foot. Fem pop bypass can relieve pain and swelling from severe peripheral arterial disease (PAD) and critical limb ischemia (serious PAD causing severely reduced blood flow).

Who qualifies for fem pop bypass surgery?

At Penn Medicine, we recommend other options before open surgery whenever possible. Medical management (such as medicine and compression stockings) or minimally invasive endovascular procedures may be a good fit for you.

In some cases, surgery is the most effective treatment. We may recommend femoral popliteal surgery when PAD symptoms:

  • Cause nonhealing foot or leg wounds, gangrene, or other infection
  • Have not improved with medication, compression sleeves, and other medical management
  • Include decreased blood flow that puts you at risk of limb loss
  • Interfere with your ability to work or quality of life
  • Involve pain when walking short distances (claudication) or resting

How long do the effects of this surgery last?

For some people, fem pop bypass surgery lasts the rest of their lives. The most common complication of this surgery for peripheral artery disease is that the new graft becomes blocked. In that case, you may need an endovascular procedure or a repeat bypass.

After the bypass surgery, you’ll have regular ultrasound scans to measure blood flow in the new leg graft. The scans can warn us if the graft isn’t working as expected. We perform this vascular ultrasound testing at our vascular testing and diagnosis labs.

Deep vein arterialization as an alternative to fem pop

Some individuals with very advanced PAD and critical limb ischemia are not candidates for endovascular or surgical bypass techniques. For these patients, Penn Medicine vascular surgeons offer deep vein arterialization (DVA).

This newer procedure offers hope to people who have such severely reduced blood flow that we cannot attach a graft. Instead, in DVA, we use healthy veins (instead of diseased arteries) to carry blood into and through your foot. By restoring blood flow, DVA can enable wounds to heal and relieve chronic pain.

Fem pop bypass for blocked leg artery: The Penn Medicine difference

At the Penn Vascular Surgery and Endovascular Therapy Program, you’ll find:

  • Trusted expertise in graft surgery: You benefit from our team’s expertise and close collaboration as we work to advance all types of vascular graft procedures.
  • State-of-the-art technology: You’ll receive surgical care in Penn Medicine’s new heart and vascular facilities, where our doctors have access to the latest technology. We deliver your postsurgical care in our well-equipped heart and vascular intensive care unit (ICU). And advanced testing enables us to monitor your health before, during and after treatment.
  • Comprehensive limb preservation care: Our surgeons perform femoral popliteal bypass surgery as part of the Penn Medicine Advanced Limb Preservation. This multidisciplinary program brings together all of your care related to severe peripheral artery disease or leg wounds. We work to restore blood flow and healing to your limb to prevent limb loss.

 

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