What Is an Axillo-Femoral Bypass?

Jennifer Long

An axillo-femoral bypass, also called an axillofemoral bypass graft, is a type of surgery. It is performed to repair a blockage located within the main artery, which sends blood to the legs from the heart. This surgical procedure involves adding an artificial artery. The new artery, made of plastic, is connected to the arteries of the collarbone and groin to allow proper, uninhibited blood flow to the legs.

A patient will be given anesthesia prior to an axillo-femoral bypass.
A patient will be given anesthesia prior to an axillo-femoral bypass.

Surgical revascularization is a fairly common method of treatment for problems with the vascular system that prevent blood from flowing properly to or away from the heart. Although graft shunts can be placed in problematic vessels to open them back up, shunts are not always ideal options. In many instances, there is too much damage to the vessels for shunts to be effective.

An artery transports oxygen-rich blood to various parts of the body.
An artery transports oxygen-rich blood to various parts of the body.

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The blood carries nutrients and oxygen through the body to tissue and organs that rely on it. When the artery to the legs is blocked, the legs are starved of these nutrients and vital oxygen. Sufferers experience pain in the legs as the most noticeable symptom, but the legs may also seem cold to the touch and sometimes numb. A lack of blood flow increases the risk of infection, even from the smallest injury, and the tissue begins to die because it does not have the oxygen or nutrients necessary to help the tissue cells stay alive and replicate. Undergoing an axillo-femoral bypass as early as possible is crucial, particularly in preventing the loss of the legs.

Axillo-femoral bypass is used to correct a blockage in the main artery of the heart.
Axillo-femoral bypass is used to correct a blockage in the main artery of the heart.

An axillo-femoral bypass procedure is performed by an experienced surgeon, and the patient is given general anesthesia to induce sleep. The surgeon makes incisions under the collarbone and in each groin in order to locate the collarbone artery and the groin artery. Before putting the plastic artery in place, the surgeon will make a tunnel beneath the skin surface. The artificial artery is threaded through this tunnel and attached at each end to the appropriate artery. All incisions are then closed with stitches.

Incisions made as a result of a axillo-femoral bypass may be slightly painful.
Incisions made as a result of a axillo-femoral bypass may be slightly painful.

Following the axillo-femoral bypass surgery, a hospital stay is necessary. Doctors must monitor the patient to ensure that blood flow has returned and infection does not occur. Patients will have an intravenous line in one arm that is hooked to bags of fluids or medications. Incisions will be slightly painful, and pain relief medications are offered. The surgeon may also place small drainage tubes around the wounds to prevent the accumulation of blood and fluids in the area.

The blood carries nutrients and oxygen through the body to tissue and organs that rely on it.
The blood carries nutrients and oxygen through the body to tissue and organs that rely on it.

Movement will be limited for a few days following the axillo-femoral bypass. Although the legs may begin to show signs of blood flow, such as warmth, patients are not encouraged to move around until the second day. Dressings on the wounds are generally removed in a few days, and drainage tubes come out in about two to three days. Patients are often allowed to go home within three to four days and are given strict instructions for activity levels and resting.

The surgical sites should be covered with sterile dressings for several days after an axillo-femoral bypass.
The surgical sites should be covered with sterile dressings for several days after an axillo-femoral bypass.
If the artery to the legs becomes blocked, the legs won't receive proper amounts of nutrients and oxygen.
If the artery to the legs becomes blocked, the legs won't receive proper amounts of nutrients and oxygen.
A hospital stay is often needed following an axillo-femoral bypass procedure.
A hospital stay is often needed following an axillo-femoral bypass procedure.

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