Aorto-Iliac Bypass in Nice
Dr. Ilya Khantalin, Vascular Surgeon in the Alpes-Maritimes
Aorto-Iliac Bypass
Dr. Ilya Khantalin in Nice
The aorto-iliac bypass is a vascular surgical procedure used to treat conditions caused by obstruction or narrowing (stenosis) of the main arteries supplying the lower limbs—specifically, the iliac arteries. This type of bypass aims to restore adequate blood flow and prevent serious complications such as gangrene or limb amputation.
Endovascular techniques are currently the most modern and widely used methods by vascular surgeons, in accordance with the recommendations of the French Haute Autorité de Santé and integrated into standardized surgical practice protocols.
Vascular diseases are recognized as Long-Term Conditions (Affections de Longue Durée – ALD), making them eligible for 100% coverage by the French Social Security system.
What is an Aorto-Iliac Bypass?
Vascular Surgeon in Saint-Laurent-du-Var
An aorto-iliac bypass is a surgical procedure performed by a vascular surgeon to bypass a blockage in the iliac arteries, which are the main vessels supplying blood to the lower limbs. The procedure involves creating an alternative route for blood by connecting the aorta (the body’s main artery, originating from the heart) to the iliac artery using a graft, typically made from synthetic material or, in some cases, a vein harvested from the patient.
The iliac arteries are located in the lower abdomen near the hips and are responsible for supplying blood to the legs. Blockages in these arteries are often due to atherosclerosis, a condition in which fatty deposits build up on the arterial walls, narrowing the vessels and reducing blood flow to the lower limbs.
The aorto-iliac bypass restores this blood flow, thereby reducing the risk of serious complications such as leg pain, impaired mobility, or limb amputation.
Indications and Procedure for an Aorto-Iliac Bypass
Vascular Surgery Specialist in Saint-Laurent-du-Var
Indications for an Aorto-Iliac Bypass
- Chronic Obstructive Arterial Disease (COAD): The most common reason for aorto-iliac bypass surgery. It is characterized by a gradual reduction in blood flow to the legs due to atherosclerosis. Symptoms include intermittent claudication (pain while walking), non-healing ulcers or wounds, and increasingly severe pain at rest.
- Acute Limb Ischemia: A sudden loss of blood supply to the legs, often caused by embolism (a migrating blood clot) or worsening arterial stenosis. This condition may cause sharp pain, discoloration of the legs and feet, and in severe cases, gangrene.
- Preoperative preparation for another surgical procedure: In some cases, the aorto-iliac bypass is performed in conjunction with other procedures, such as abdominal aortic aneurysm repair, when lower limb blood flow is compromised.
- Failure of non-surgical treatments: When medications or endovascular treatments (e.g., angioplasty) fail to improve circulation and symptoms persist, surgical intervention becomes necessary.
Procedure
The aorto-iliac bypass is performed under general or regional anesthesia, depending on the patient’s condition and the complexity of the procedure. The surgeon makes an incision in the lower abdominal area to access the aorta and iliac arteries.
A graft, typically made of polyester or Dacron, is then sutured between the aorta and the iliac artery, bypassing the blockage or narrowing. This restores blood flow to the lower limbs, providing immediate relief from symptoms and improved tissue perfusion.
The operation generally lasts between 2 and 4 hours, depending on the complexity of the case.
Postoperative Follow-up
Following an aorto-iliac bypass, careful postoperative monitoring is essential to ensure the success of the procedure and to prevent complications. The patient is observed in intensive care or a hospital room, depending on their condition. The first hours post-surgery are critical for monitoring vital signs, limb perfusion, and early signs of infection.
Follow-up continues in the weeks and months after the procedure. Regular consultations with the vascular surgeon are scheduled to monitor blood flow and incision healing. Additional exams, such as Doppler ultrasound or CT angiography, may be performed to verify graft patency and detect complications like blood clots.
Possible Complications
While generally safe, aorto-iliac bypass surgery—like any major operation—carries some risks, including:
- Infection at the surgical site
- Graft thrombosis, which may lead to renewed arterial blockage
- Postoperative bleeding
- Nerve injury due to the abdominal incision
- Acute ischemia if the graft becomes blocked
Rehabilitation and Return to Normal Life
After surgery, rehabilitation is often recommended to enhance blood circulation and improve mobility. This may include walking exercises, physical therapy, and lifestyle counseling (quitting smoking, managing diabetes, adopting a healthy diet) to reduce the risk of recurrence.
Returning to normal life usually occurs after a few weeks of recovery, depending on the patient’s overall health and healing progress. Long-term follow-up is crucial to monitor the condition of the bypass and prevent future complications.
The aorto-iliac bypass is a key intervention for patients with vascular disorders of the lower limbs. By restoring optimal blood flow, it provides an effective solution for both acute and chronic leg ischemia. Rigorous medical follow-up and appropriate risk factor management are essential to ensure long-term success and prevent complications.