Femorofemoral (femoral-femoral) bypass is a technique to enhance the blood supply to the leg and ease patient indications that may occur due to outer iliac vein occlusive ailment. This ailment may happen due to dynamic ulcers or gangrene and may eventually lead to amputation.
At such times Femorofemoral Bypass is a crucial option. The doctor may also let you consider other options such as aorto-bifemoral, iliofemoral, or axillofemoral. However, these will rely upon the degree and position of the blockage in your leg vein and what the specialist feels as the best choice.
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A Femorofemoral bypass is recommended:
- When a patient has lower-extremity ischemia (claudication or extreme pain in the legs during exercise, pain at the time of rest, loss of tissue) caused by chronic or acute blockage of the iliac artery system of one side
- As a supplement to endovascular unilateral aorto iliac exclusion of an abdominal aortic aneurysm
- In critical patients with additional issues such as cardiopulmonary disease, numerous earlier abdominal operations, previous radiation therapy of the abdomen or stoma in the abdomen, where in-line reconstruction with inflow from the proximal iliac artery or the aorta is hampered
- When percutaneous, endovascular intervention fails, Femorofemoral bypass is a safe and effective option for limb salvage
- Non-invasive blood vessel physiologic investigations, including lower leg brachial file (ABI) and blood vessel wave shape examination by duplex ultrasonography. In the event that iliac occlusive illness is suspected, no less than one imaging study ought to be performed for appraisal of the blood vessel life systems.
- Figured tomography angiography (CTA), attractive reverberation angiography (MRA), or arteriography gives anatomic data to the required revascularization technique.
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- Femorofemoral sidestep is frequently performed with general anaesthesia on the grounds that burrowing of the unite can be hard to endure. In situations where fundamental cardiopulmonary sickness blocks general anaesthesia, be that as it may, the system can be performed with local (spinal) or neighbourhood anaesthesia and sedation.
- The surgery is performed with the patient situated recumbent, and a wide sterile field is set up from the belly to the lower front thighs.
- The femoral arteries are exposed bilaterally with longitudinal or sideways incisions. This method is highly favourable as it gives better access to both proximal and distal femoral veins. The necessary procedure is performed to ensure preservation of the deep femoral arteries.
- The tunnel is then created for the Femoro Femoral bypass before systemic heparinization. This tunnel is made mostly in the prefascial subcutaneous plane. However, under certain circumstances such as scarring of the abdomen, damage to the skin or other abdominal issues, this tunnel may be made in the space of Retzius (preperitoneal). At such times, due care is taken to prevent any harm to the internal viscera.
- Femorofemoral bypasses are done by use of prosthetic grafts that are then joined with the artery. The tunneling is done carefully considering the size and dimensions of the graft so that it does not kink or become unduly tensed.
- Once the tunnel is ready, the graft is tunnelled from incision on one side of the groin to the other using blunt finger dissection, a suitable clamp or a tunnelling device over the prefascial subcutaneous plane within the abdominal wall above the pubis. inside the stomach divider better than the pubis.
- The polytetrafluoroethylene (PTFE) or Dacron graft is then passed across the tunnel and arranged as an inverted C or U so that it converges longitudinally at the anastomoses.
- The surgical wounds must be taken care of thoroughly to prevent infections
- The doctor may recommend necessary medications that must be given regularly.
- Painkillers may be prescribed for pain
- The patient may be allowed to stand on the first day after operation and may be able to walk with help or support after 3 days.
- Blood thinning medications may also be given to prevent clots.
- You must rest for 2-3 weeks after the operation
- You will be able to drive after 4 weeks of surgery.
- You can resume light work after 2 weeks of surgery and heavy work only after 4 weeks
Risks in Femorofemoral Bypass
- Bypass blockage
- Femoral nerve damage
- Graft thrombosis and distal emboli
- Graft contamination
Cost involved in Femorofemoral Bypass
The following are the primary factors that determine the cost involved in Femorofemoral Bypass:
- Hospital that patient chooses for his/her treatment (if required)
- Fees for the doctor/physician
- Cost of surgical procedures (if required)
- Cost of follow up care
- Cost of medicines
- Cost of tests and diagnostic procedures