Femoro-popliteal Bypass Using a Prosthesis in Nice
Dr. Ilya Khantalin, Vascular Surgeon in Alpes-Maritimes
Femoro-popliteal Bypass Using a Prosthesis
Dr. Ilya Khantalin in Nice
The femoro-popliteal bypass using a prosthesis is a vascular surgery procedure intended to treat peripheral arterial diseases, notably ischemia of the lower limbs. Performed in a specific clinical context, this type of bypass aims to restore blood flow in the legs by bypassing blocked or narrowed areas of the arteries. Dr. Ilya Khantalin, vascular surgeon in Saint-Laurent-du-Var, presents this procedure, its indications, the surgical process, as well as the necessary care and follow-up.
Endovascular techniques today represent the most modern approaches and are the most commonly used by vascular surgeons, in accordance with the recommendations of the Haute Autorité de Santé and integrated into standardized surgical practice protocols.
Vascular diseases are recognized as Long-Term Conditions (ALD), which allows 100% coverage by Social Security.
What is femoro-popliteal bypass using a prosthesis?
Vascular surgeon in Saint-Laurent-du-Var
Femoro-popliteal bypass using a prosthesis is a surgical procedure that involves bypassing an obstruction in the femoral or popliteal artery (the main arteries of the lower limbs) using an artificial conduit, usually a synthetic prosthesis. The goal is to restore blood circulation by allowing blood to bypass the blocked section of the artery. This type of bypass is often used when other treatment methods, such as angioplasty or decompression surgery, are not possible or effective.
The procedure consists of connecting the femoral artery (located in the upper thigh) to the popliteal artery (located behind the knee) using a prosthesis, often made of polyester or PTFE (polytetrafluoroethylene), a material particularly suited because of its durability and biocompatibility.
Indications and procedure of femoro-popliteal bypass using a prosthesis
Vascular surgery specialist in Saint-Laurent-du-Var
Indications for femoro-popliteal bypass using a prosthesis
Femoro-popliteal bypass is mainly recommended in cases of peripheral arterial occlusive disease (PAOD), a condition linked to atherosclerosis that causes narrowing or occlusion of the arteries. This pathology reduces blood flow, which can cause pain, ulcers, or even gangrene in severe cases. The surgery is often considered when:
- The artery obstruction is severe and angioplasty (balloon dilation) or stent placement are not viable options.
- Critical limb ischemia is present, meaning the tissues of the limb suffer from insufficient blood supply, resulting in rest pain, ulcers, or signs of gangrene.
- Intermittent claudication pain no longer responds to medical treatments or less invasive interventions.
- The arteries of the lower limbs are not healthy enough to allow bypass using autologous vein grafts (from the patient’s own veins).
Procedure of the surgery
Before any surgery, a precise evaluation of the patient’s vascular condition is performed. Exams such as Doppler ultrasound, CT angiography, or vascular MRI help locate the obstruction and assess the arteries’ viability. Once the indication is confirmed, the operation is scheduled under general or regional anesthesia, depending on the patient’s situation and preference.
The surgeon makes an incision on the thigh and behind the knee to locate the femoral and popliteal arteries. Once identified, the prosthesis is placed to create an artificial passage bypassing the obstructed zone. The prosthesis is then sutured at each end, and the surgery concludes with a check of the blood flow.
The operation usually lasts between 1 and 3 hours, depending on the complexity of the case.
Associated risks
Like any surgery, femoro-popliteal bypass using a prosthesis carries risks, though they are relatively rare. Possible complications include:
- Infection: Any surgery can lead to infection, although the risk is low thanks to strict sterilization protocols.
- Thrombosis or clots: Clot formation within the prosthesis or arteries can impair blood flow.
- Prosthesis-related problems: The prosthesis can narrow, detach, or become obstructed long-term.
- Cardiac or pulmonary complications: Especially in patients with cardiovascular history.
It is essential that every patient is fully informed about the risks before surgery.
Follow-up after femoro-popliteal bypass using a prosthesis
After the operation, hospitalization for a few days is usually necessary to monitor recovery progress. Post-operative follow-up involves several aspects:
- Monitoring blood flow: Exams like Doppler ultrasound verify the bypass’s proper function and ensure no obstruction occurs.
- Wound care: Monitoring for infection is crucial, and wounds must be kept clean.
- Prevention of thromboembolic complications: Anticoagulants may be prescribed to prevent blood clots in the prosthesis.
- Rehabilitation and physical activity: Gradual resumption of physical activity is recommended to promote circulation and limb rehabilitation. Physical therapy may be advised to strengthen muscles and improve mobility.
Long-term follow-up is necessary, with regular check-ups to ensure the durability of the bypass and prevent complications.
Femoro-popliteal bypass using a prosthesis is an increasingly used vascular surgery technique to treat severe arterial diseases of the lower limbs. It restores blood flow in cases of severe obstructions when other treatments are ineffective. Thanks to precise surgery and rigorous follow-up, the bypass can significantly improve patients’ quality of life and reduce the risk of amputation.
Dr. Ilya Khantalin, specialist in vascular surgery in Saint-Laurent-du-Var, supports you throughout your care journey, providing therapeutic solutions and follow-up tailored to your specific needs.
Do not hesitate to consult your vascular surgeon for more information or for an evaluation of your vascular condition.