Aortoiliac bypass and aortofemoralnoe

Description aortoiliac bypass and aortofemoralnogo

In operation, artificial blood vessels (graft) sewed into a blood vessel, which is blocked or narrowed. The transplant allows blood move around the site blocking. When executed, the grafts are placed on the aorta and iliac or femoral arteries.

The aorta is the main artery, which carries oxygenated blood throughout the body. At the level of the navel aorta divides into two iliac arteries. At the level of the groin into the iliac arteries pass femoral artery.

Aortofemoralnoe bypass is also called aorto-femoral bypass bifurcation. The graft is formed by this operation in the form of an inverted “AND”

Most bypass operations includes the traditional way, through an open incision. Carries out research, to develop the technique of this operation using laparoscopic or mini-laparotomy technique. Their use is much smaller incisions.

Reasons aortoiliac bypass and aortofemoralnogo

To have a good blood flow to the lower body, It should be a good blood flow through the aorta, iliac and femoral arterib. This may prevent atherosclerosis – disease, in which fatty plaque (plaques) is formed on the walls of blood vessels. The plaques block the normal flow of blood to the affected blood vessels. When blood flow is reduced, cloth, are blocked, do not get enough oxygen. This can lead to the following consequences:

• Pain, which increases prihodbe foot or exercises (It called intermittent claudication);
• Cold legs or feet;
• Scale, dry, red, itchy, or brown skin on the legs and feet;
• Non-healing and / or infected sores on the legs or feet;
• Gangrene;
• The need for amputation of the feet;
• Nerve Damage.

The operation can restore blood flow to the feet.

Possible complications when performing aortoiliac bypass and aortofemoralnogo

When planning the operation you need to know about possible complications, which may include:

• Infection;
• Obstruction of the new graft by blood clots;
• Bleeding;
• Complications from anesthesia;
• Scarring;
• Nerve Damage.

Factors, that may increase the risk of complications:

• Heart or lung disease;
• Diabetes;
• Obesity;
• Smoking;
• Kidney or liver disease;
• Advanced age;
• Infection.

How is the aortoiliac bypass and aortofemoralnoe?

Preparing for Surgery

The doctor performs the following tests:

• Physical examination;
• Blood tests;
• The ankle-brachial index – test compares the blood pressure in the arms and legs. These numbers should be very similar. If the pressure is much lower legs, than on the hands, it speaks of a blockage in the arteries, that supply blood to the legs;
• Doppler ultrasound – This test uses sound waves to study the blood flow in the arteries. It can determine the, which arteries are blocked;
• Angiography – injected into the arteries special dye and X-rays are performed legs. Because the dye will not be able to pass through areas narrowed or blocked by plaque, will identify specific problem areas . Other types of non-invasive angiography, which are currently in use may also include CT angiography and magnetic resonance angiography.

Before surgery

• The day before the operation can take only a light meal. On the day of surgery can not eat anything;
• It is necessary to prepare for the return home from the hospital after surgery;
• It may be necessary to stop taking some medicines:
  • Aspirin or other anti-inflammatory drugs;
  • Blood thinners, eg, clopidogrel (Plaviks) or warfarin.

Anesthesia

During the operation using general anesthesia. During the operation, the patient is asleep. To facilitate the breathing tube is inserted into the throat for ventilation.

Sometimes additionally used an epidural, which blocks the lower body. This type of anesthesia is injected into the spinal column.

Description and operation aortoiliac bypass aortofemoralnogo

The stomach is carried out a large incision. The muscles around the abdomen cut. To reach the blood vessels, some organs should be carefully moved aside.

The blood flow through the vessels is stopped – for this purpose on both sides of the blocked vessel clamps will be placed, to stop the blood flow. Then the graft is sewn. One end of the graft is attached to the aorta just above the lockout. The other end is attached directly to the place after the lock on the femoral or iliac artery.

The clamps are removed. The doctor examines the surgical site, to ensure there is a good blood flow through the graft. Internal organs will be put in place. Cut the abdominal muscles are joined together and sewn. The skin incision on the abdomen closed with sutures or staples.

After surgery, aortoiliac bypass and aortofemoralnogo

After surgery, the patient is placed in the recovery room. The breathing tube in the throat can be removed, or, perhaps, will have to be left for several days. Epidurals can also be extended for a few days. Will be monitored for any adverse reactions to the surgery or anesthesia.

How long does the surgery?

The operation takes about three to four hours.

Will it hurt?

Anesthesia will prevent pain during surgery. The incision on the abdomen can cause pain after surgery. For the relief of pain the patient is administered pain medications.

The time spent in hospital

The usual length of stay is 5-7 days. Duration of hospital stay will depend on the health and speed of recovery. The doctor can extend the time spent in hospital, If there are complications.

Postoperative care after aortoiliac bypass and aortofemoralnogo

In the hospital

The patient will need to spend 1-2 days in bed after surgery.

• Will be operated under the close supervision in the intensive care (OBE). The patient may be there for 1-2 days as needed;
• Spirometry is used every two hours during the day. This will keep the lungs as open as possible and avoid pneumonia;
• Nasogastric tube may be inserted during surgery through the nose down, in life. The intestine after surgery often does not operate properly. The patient can not eat or drink anything, until it begins to function again. The tube is then removed. The patient is gradually transferred to the liquid food to soft, and, finally, restore regular, everyday food.
• Patients may be administered daily drugs, to avoid the formation of blood clots.

Nursing homes

After the procedure, be sure to follow your doctor's instructions:

• Support the incision clean and dry;
• We need to ask the doctor about, when it is safe to shower, bathe, or to expose the surgical site to water;
• The patient can resume normal activities within six weeks after surgery;
• It is necessary to follow the doctor's instructions regarding, when you can begin to move, perform exercises, lift things and strain.

It is necessary to go to the hospital in the following cases

• Redness, edema, strong pain, bleeding, or discharge from the incision site;
• Inability to relieve pain using painkillers;
• Signs of infection, including fever and chills;
• Nausea and / or vomiting, which continue for more than two days after discharge from the hospital, and do not stop after taking the appropriate medication;
• Difficulties, pain, burning, high frequency, bleeding during urination;
• Cough, shortness of breath or chest pain;
• The feet become cold, pale, blue, there is tingling or numbness;
• Pain or swelling in the legs, ykrah, or feet.