Are your leg veins blocked? Let's learn about Peripheral Artery Bypass surgery in a simple way!

Do you also experience pain in your legs, especially when you walk for a short distance? Does the pain subside when you stop for a while and then walk again? Or do you wake up at night with pain in your legs? These may not be just any other common leg pain. The reason behind this may be a blockage in the main blood vessel that supplies blood to your legs. Today, we will talk about Peripheral Artery Bypass, a major surgery performed for this.

Simply put, what is Peripheral Artery Bypass?

This is a surgery. This surgery involves creating a new path for blood flow to bypass a blocked or narrowed artery in your leg (or sometimes your arm).

Imagine this. There's a big traffic jam on a road you usually take, and the road is completely blocked. Now you can't go any further. What do the road builders do then? They build a new bypass road to avoid the traffic. That's how this surgery is.

Cholesterol and other fats build up in the blood vessels of our body, forming a "fatty layer." In medicine, this is called plaque . Over time, this fatty layer grows and blocks the blood vessels. We call this condition Peripheral Artery Disease (PAD) . When this blood flow becomes blocked, the tissues in your legs do not receive the oxygen and nutrients they need. That's when the doctor creates a new blood flow path (a graft) by connecting the arteries above and below the blockage.

Who really needs bypass surgery?

This surgery is not for everyone. Your doctor will first try to control your condition with medications and lifestyle changes (such as quitting smoking and exercising). However, surgery is only considered if none of these are effective and if a large section of your blood vessel is severely blocked.

If you have the following symptoms, your doctor may recommend this surgery.

What happens before the surgery?

Your vascular surgeon will order several tests to determine your exact condition before surgery.

• ECG (Electrocardiogram): Check the functioning of the heart.
• Ultrasound Scan: To find out exactly how blood flows in the blood vessels and where there are blockages.
• Blood Tests: Check for things like diabetes and cholesterol levels.
• Stress Test: See how your heart responds when you exercise.

Along with these tests, there is one important thing you need to do. If you smoke, stop smoking immediately. This will greatly help you reduce the risk of complications after surgery.

The day before surgery, your doctor will give you these instructions:

• Some medications (especially those that prevent blood clotting) may need to be temporarily stopped.
• They say not to eat or drink anything after midnight the night before the surgery.

What happens during the surgery?

Because this is a major operation, the anesthesiologist will put you completely asleep so that you don't feel any pain. Then the surgeon will follow these steps:

1. Incision: Two incisions about 4-8 inches long are made above and below the blocked blood vessel.

2. Taking a vein for the bypass (Graft):A new bypass requires a vein. This is often a healthy vein from your own leg. Or a plastic or fabric graft is used. If you use your own vein, you will need to make another small incision to get it.

3. Creating a new path: The graft is sewn to the main blood vessel, with one side above the blockage and the other side below the blockage. The blood can now bypass the blockage and flow down this new path.

4. Closing the incisions: Finally, the incisions are closed with stitches or staples.

The entire procedure can take anywhere from two to six hours, depending on the length of the blocked artery and the complexity of the surgery.

What to expect after surgery?

After the operation, you will be transferred to the ward, where the medical staff will be constantly monitoring you for:

• Your pulse, blood pressure, temperature, and breathing are constantly checked.
• They always check to see if the leg that underwent surgery has good blood circulation.
• Painkillers are given to control the pain.

When you go home from the hospital, the doctor will prescribe several medications for you to continue taking.

• Statins: Control cholesterol.
• Aspirin or Clopidogrel: Prevent blood clots.

Benefits and risks of surgery

Like any surgery, this one has benefits as well as some risks.

Things to consider during recovery and after returning home

It can take about 6 to 8 weeks to fully recover. However, you should be able to gradually return to your normal activities within a few weeks. You will usually be discharged from the hospital within 2-5 days.

These things can usually happen after you get home, don't be afraid:

• Decreased appetite.
• Feeling pain or tingling around the incisions.
• The leg is a little swollen.
• Feeling pain in the muscles when walking.

When to call the doctor immediately!

If you develop any of the following symptoms after returning home, notify your doctor immediately or go to the hospital's Emergency Department (ETU) .

• If you have a high fever or if you are shivering with cold.
• If there is pus-like fluid coming from the stitches, they are red, swollen, and in extreme pain.
• If the color of the leg changes (turning pale or blue), if the leg becomes extremely cold, or if the tingling increases.

After the surgery, the doctor will give you a date to come back for a follow-up. Be sure to attend these clinics. There, the doctor will perform an ultrasound scan to see if your bypass is working properly.