General Information

DEFINITION--Placement of an artificial graft to bypass a blood clot or artery closure in the arteries that supply blood to the abdomen, genital area and legs.

BODY PARTS INVOLVED--Aorta; iliac arteries.

REASONS FOR SURGERY--Restoration of normal blood circulation in the legs.

SURGICAL RISK INCREASES WITH

• Alcoholism; obesity; smoking.
• Diabetes mellitus; coronary artery disease; or atherosclerosis.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; narcotics; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES--General surgeon or vascular surgeon.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; arteriograms (See Glossary).
• After surgery: Blood studies.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made in the abdomen.
• The abdominal muscles are separated to expose the abdominal organs, which are inspected for undetected disease. (Other surgeries may be performed at this time.)
• The aorta and iliac arteries are located and clamped to isolate the obstruction.
• An artificial graft is fashioned and fitted in place. One end fits in the aorta and the other two ends in the iliac arteries.
• The graft is sewn in place and the clamps are released. Blood can now circulate freely.
• The muscles of the abdomen are closed in layers. The skin is closed with sutures or clips, which usually can be removed about 1 week after surgery.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Incisional hernia.
• Inadvertent injury to the ureter.
• Impotence; graft infection.
• Occlusion of arteries beyond the grafted vessels.

AVERAGE HOSPITAL STAY--10 to 14 days.

PROBABLE OUTCOME--Expect complete healing without complications and restoration of normal circulation to legs. Allow about 6 weeks for recovery from surgery.

Postoperative Care

> Move and elevate legs often while in bed to decrease the chance of deep--vein blood clots.

> You may use non--prescription drugs, such as acetaminophen, for minor pain.

> To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Avoid vigorous exercise for 6 weeks after surgery. Your doctor will prescribe an exercise program. > Resume driving 5 weeks after returning home. > Resume sexual relations when your doctor has determined that healing is complete.

DIET--Clear liquid diet until the gastrointestinal tract begins to function again. Then eat a well--balanced diet to promote healing. After recovery, your doctor may recommend a diet low in fat and sodium (see Appendix for both diets).

Call Your Doctor If

> Pain, swelling, redness, drainage or bleeding increases in the surgical area.