The femoral artery is the largest blood vessel carrying blood to the legs. It runs from the lower abdomen into the thigh, becoming the popliteal artery at the knee. Some health conditions reduce blood flow through these arteries, causing pain, swelling, problems with wound healing and risk of amputation.
At Penn Medicine, our vascular surgeons have a depth of experience in femoral popliteal (fem pop) bypass, an advanced procedure to restore blood flow and prevent limb problems from worsening. We carefully assess your condition. If surgery is needed, we offer highly successful procedures to help restore your mobility and comfort.
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
What to Expect from the Procedure
Fem pop bypass is a surgical procedure performed in the hospital. Your care team includes vascular surgeons, nurses, technicians and a vascular anesthesiologist. During the procedure:
- You may have general anesthesia (to put you to sleep) or a spinal block so you don’t feel any pain. Our dedicated vascular anesthesiologist closely monitors you during the procedure.
- Your surgeon makes two incisions, one near your groin crease and one near your knee or ankle. If the graft is your own blood vessel, you will have other incisions, usually on your inner thigh.
- The surgeon sews the graft to your artery at both ends and closes the incisions.
You stay in the hospital for a few days after a femoral popliteal bypass surgery. You’ll need to take a few weeks off work. Your leg will be very sore at first, but then your leg wounds will heal. Most people fully recover within four to 12 weeks.
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 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.
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.
Schedule Your Appointment
Call 800-789-7366 or request a callback.