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.
- You develop signs of infection: headache, muscle aches, dizziness or a general ill
feeling and fever.
- You experience new symptoms, such as nausea, vomiting, constipation or abdominal
swelling.
- Your feet become cold, discolored or numb.
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