Atherosclerosis is a disease characterized by the accumulation of fatty deposits on the walls of arteries, which narrows and hardens the lumen, gradually causing blockage of the blood vessels. In this condition, blood cannot reach the tissues to nourish them, and the muscles start to contract and lose their strength. Atherosclerosis can develop in any of the body's arteries and often affects multiple arteries simultaneously.
Atherosclerosis in the lower extremities can initially manifest as cramping and pain in the calf (in one or both legs), especially after walking. As the disease progresses, the pain may also occur at rest, and in severe cases, ulcers and gangrene can develop, requiring amputation of the affected limb.
Additional symptoms include reduced sensation in the legs, decreased hair growth on the legs, changes in skin color, a sensation of cold in the feet, and thickened toenails. Patients with atherosclerosis in the legs are at an increased risk of developing atherosclerosis in the coronary and cerebral arteries, which can lead to heart attacks and strokes.
During a bypass surgery for atherosclerosis, a new pathway for blood flow is created by redirecting blood from the blocked artery through a synthetic tube or a vein graft from the patient. The surgery is typically performed under general or regional anesthesia. The surgeon makes an incision at the site of the blocked artery and places the graft (synthetic tube or a segment of the patient's vein) above and below the blockage to allow blood to flow beyond the obstruction. Each patient is individually assessed, and the treatment is chosen according to their specific circumstances.
The surgery is performed in an operating room in the hospital by a vascular surgeon and usually lasts between three to five hours. It requires minimal hospitalization, usually four to seven days. Some patients may require admission to an intensive care unit for one or two days for close monitoring. Most patients undergo physiotherapy during their recovery period.
Bypass surgery is generally performed without complications, but there is a certain risk of damage to blood vessels, minor swelling in the leg, or surgical wound complications. Special precautions are taken to minimize these risks. Before the surgery, the patient meets with the vascular surgeon and receives detailed explanations about the procedure, potential risks, and pre-and post-operative instructions. Additionally, after any surgical procedure, mild fatigue for a few weeks or mild discomfort along the incisions may occur.
Restoring blood flow through surgical bypass usually provides significant relief from the symptoms. However, if the patient does not adopt a healthy lifestyle, atherosclerosis can recur.