Peripheral Vascular Surgery
Peripheral vascular surgery is the surgical treatment of peripheral artery disease (PAD). Doctors recommend peripheral vascular surgery for patients with PAD that have not responded to medications or lifestyle changes like healthy eating and exercise.
Common forms of peripheral vascular surgery include:
- Peripheral vascular bypass surgery.
The goals of these peripheral artery interventions are to improve circulation, decrease pain, improve limb function, and prevent amputation.
Why choose Presbyterian for your peripheral vascular surgery?
Presbyterian Heart and Vascular Care has a skilled vascular care team who can provide a wide range of services from diagnosis to treatment. Their surgeons are trained in many different techniques and procedures, many of which can provide you with a shorter recovery period and less hospital time.
Who is eligible for a peripheral vascular surgery?
If non-coronary angioplasty and other treatments or lifestyle changes do not work on your PAD, or if multiple vessels are blocked, you may be eligible for peripheral vascular surgery.
Symptoms of PAD that may lead to treatment include:
- Leg numbness or weakness.
- A change in the color of your legs.
- Sores on your toes, feet, or legs that won't heal.
- Coldness in your lower leg or foot, especially when compared with the other side.
- Painful cramping in one or both of your hips, thighs, or calf muscles after certain activities, such as walking or climbing stairs.
What conditions can be treated with a peripheral vascular surgery?
Peripheral vascular surgery is used to treat PAD. In PAD, the blood vessels leading to the arms and legs are narrowed or clogged, so blood has a hard time getting through. Blood carries oxygen, which is essential for the normal functioning of your body's tissues. Decreased blood flow to the limbs increases the risk of tissue death, which may require amputation.
How do I prepare for a peripheral vascular surgery?
You can prepare for peripheral vascular surgery by:
- Answering all of your doctor's questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. Temporarily taking or stopping medications for some period of time before the surgery may be necessary. This may mean not taking aspirin, ibuprofen, and blood thinners. Your doctor will advise you.
- Getting preoperative testing as directed. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), blood tests, and other tests as needed. These tests help ensure you are in good overall health for surgery. Your doctor will let you know if you need any of these.
- Following all instructions about eating and drinking before surgery.
- You may also need a ride home from the hospital.
What should I expect during my peripheral vascular surgery?
The details of your surgery will depend on which surgical procedure is performed.
- Endarterectomy: The surgeon opens the affected blood vessel and scrapes out any plaque blocking the vessel. The surgeon may also remove diseased portions of the blood vessel and reconnect the healthy sections. With general anesthesia, you’ll be asleep throughout the procedure. You’ll be awake and alert for regional anesthesia but unable to feel anything at the surgical site. Endarterectomy usually takes about two to three hours.
- Bypass Surgery: Your surgeon creates a new route for blood flow with either a portion of one of your healthy blood vessels or a blood vessel made of synthetic fabric to create the new route and bypass the blocked and diseased artery. If the bypass uses one of your healthy blood vessels, you may have more than one surgical incision because they must use one from another part of your body. The surgeon attaches the graft to your affected blood vessel above and below the blockage. Peripheral bypass surgery takes two to four hours.
After surgery, you will be in a recovery room, where nurses will monitor your vital signs until the effects of anesthesia wear off.
After an endarterectomy, most people spend one to two days recovering in the hospital. People who have bypass surgery spend 3-8 days in the hospital after surgery. You may be in an intensive care unit (ICU) room for the first few days. Your care team will get you moving within 48 hours of surgery. Walking encourages blood flow and prevents common postoperative complications, such as pneumonia.
You will have pain, swelling, and possibly bruising at your incision sites. Your care team will give you pain medicine.
How do I care for myself after my peripheral vascular surgery?
It is important to keep your follow-up appointments. Your doctor needs to check your blood flow to your limbs and surgical incisions to heal properly. If you have any of these symptoms, call your doctor:
- Increased pain.
- Discoloration of your affected limb.
- Unusual swelling, redness, or warmth around your incision.
- Chest pain, chest tightness, chest pressure, or palpitations.
- Breathing problems, such as shortness of breath, difficulty breathing, labored breathing or wheezing.
- Fever. A low-grade fever—lower than 101 degrees Fahrenheit—is common after surgery, but follow your doctor's specific instructions about when to call for a fever.