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This procedure is sometimes performed on the large arteries to the legs. In certain patients, narrowing of these arteries can affect only a short segment. Instead of performing a bypass, these short segments can be treated by directly opening the artery, unblocking it, then patching it with a piece of vein or synthetic material.
Most of these procedures are performed under local or spinal anaesthetic. Most patients sleep naturally throughout and have no recollection of their time in theatre. After administration of the spinal anaesthetic, the relevant arteries are exposed, heparin is given and the arteries clamped. The diseased artery is then opened, and the occluding plaque removed. The insertion of a patch will depend on the size of the artery. Smaller arteries are usually patched. The clamps are then removed and the wound closed.
Following a short period in the recovery bay, patients are transferred back to their original wards. Oral intake is usually allowed straight away. After one to two days of bed rest, patients are encouraged mobilise gradually.
The most important complication is failure to restore adequate blood flow to the diseased arteries. This usually means that the preoperative symptoms of arterial disease will persist. In a minority of patients, more severe symptoms of arterial insufficiency may develop after a failed procedure. These patients are likely to require further surgery. If surgery was for limb salvage, this may not be possible and further surgery to save the limb may be required. Local complications may include bleeding, bruising and infection.
Admission: Day before procedure Anaesthetic: Local / spinal-epidural Stay in hospital: 4-6 days Removal of sutures: 10-14 days Time off work: Two to three weeks First follow-up appointment: 6 weeks |
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