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This is a procedure to supply one or both legs with blood using the artery of the arm as a source. Axillo-Femoral grafts are reserved for patients who are not fit enough for Aorto-Femoral bypass grafting.
These operations require general anaesthesia. An incision is made under the right clavicle (collar bone) to expose the axillary artery. One or two groin incisions are made depending on whether one or both legs require bypassing. Heparin is then given to prevent blood clotting prior to applying various clamps to the relevant arteries. A long synthetic graft is tunnelled under the skin and joined to these arteries. Following completion of graft suturing, the clamps are removed and the wounds closed.
Axillo-Femoral bypass procedures are fairly well tolerated and recovery is usually fast. Most patients will receive anticoagulants to reduce the risk of graft clotting. Patients usually start to mobilise from the third day onwards with the help of the physiotherapy team. The success of the procedure depends on various factors the most important of which is the state of the recipient arteries.
Patients who undergo Axillo-Femoral bypass surgery are by nature unwell. Cardiac and respiratory complications are therefore frequent. The graft itself is quite long which makes it less likely to last. The graft failure rate ranges between 38-65% in the first 3 years. Graft Infection is another relatively common complication affecting 9.7% of patients.
Admission: Day before surgery Anaesthetic: General Stay in hospital: 1-2 weeks Removal of sutures: 10-14 days Time off work: 4-6 weeks First follow-up appointment: 6 weeks |
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