Aortoiliac and Aortofemoral Bypass Graft Surgery
by Amy Scholten, MPH
Aortoliac and aortofemoral bypass graft surgery is to bypass a blocked artery. In this case, the aorta, and the iliac or femoral arteries are involved.
The aorta is the body's largest artery. It carries blood from the heart to the rest of the body. At the belly button level, the aorta divides into two iliac arteries. At the groin level, the iliac arteries become the femoral arteries.
Reasons for Procedure
This surgery is done to improve blood flow in the lower part of the body. Atherosclerosis is a major cause of poor blood flow. It causes blood vessels to become narrow and blocked.
In a bypass, tubes (grafts) are placed near a piece of blocked or narrowed blood vessel. Blood can then move through the graft around the blockage.
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen such as::
Things that may raise the risk of problems are:
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
Description of the Procedure
Most bypass surgery involves a traditional, open incision. Laparoscopic techniques use much smaller incisions.
A large incision will be made in the abdomen. The muscles around the abdomen will be cut. To get to the blood vessels, some organs will be carefully moved out of the way.
Clamps will be placed on either side of the blocked area. This will briefly stop blood flow. The graft will be sewn into place. One end of the graft will be attached to the aorta just above the blockage. The other end will be attached just after the blockage on the femoral or iliac arteries.
The clamps will be removed. The doctor will check for good blood flow through the graft. Organs will be put back in place. The abdominal muscles will be pulled together and stitched closed. The skin incision will be closed with sutures or staples. A bandage will be placed over the site.
How Long Will It Take?
About 3 to 4 hours
Will It Hurt?
There will be some pain and discomfort after the procedure. Medicine and home care help.
Average Hospital Stay
The usual length of stay is 5 to 7 days. If there are any problems, the stay will be longer.
At the Hospital
After surgery, the staff may:
During your stay, the hospital staff will take steps to lower your risk of infection such as:
There are also steps you can take to lower your risk of infection such as:
Recovery can take up to 6 weeks. Physical therapy may be needed to maintain or rebuild strength.
Call Your Doctor
Call your doctor if you are not getting better or you have:
If you think you have an emergency, call for medical help right away.
American Heart Association
Society for Vascular Surgery
Heart and Stroke Foundation of Canada
ICES—Institute for Clinical Evaluative Sciences
Aortofemoral bypass surgery. UCSF Department of Surgery website. Available at: https://vascular.surgery.ucsf.edu/conditions--procedures/aortofemoral-bypass-surgery.aspx. Accessed August 27, 2021.
Peripheral artery disease of the lower extremities. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/peripheral-artery-disease-pad-of-lower-extremities. Accessed August 27, 2021.
Sharma G, Scully RE, et al. Thirty-year trends in aortofemoral bypass for aortoiliac occlusive disease. J Vasc Surg. 2018;68(6):1796-1804.
Surgical bypass for aortoiliac occlusive disease. Society for Vascular Surgery website. Available at: https://vascular.org/patient-resources/vascular-treatments/surgical-bypass-aortoiliac-occlusive-disease. Accessed August 27, 2021.
Last reviewed July 2021 by EBSCO Medical Review Board Nicole Meregian, PA
Last Updated: 8/27/2021
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