Femoral Popliteal Bypass Graft
Percutaneous Transluminal Angioplasty (PTA) of the Femoral Arteries

If you have peripheral artery disease (PAD) that hasn’t responded to medical treatment, or symptoms such as leg pain or a wound that won’t heal, your doctor may recommend surgical treatment.

The aim of surgery is to improve the flow of oxygen-rich blood to your extremities by treating the narrowing or blockages of the arteries in your legs. This can relieve symptoms, enable you to resume a normal lifestyle, and reduce the risk of more serious problems.

Fortunately, the surgeons at Northwest Regional Heart & Vascular have extensive experience performing the two most advanced approaches available today for treating PAD: femoral popliteal bypass graft and percutaneous transluminal angioplasty of the femoral arteries.

What is peripheral artery disease?

Peripheral artery (or arterial) disease (PAD) is a circulation problem in which narrowed arteries reduce blood flow to your arms and legs. This narrowing is a result of atherosclerosis, the accumulation of fatty deposits (plaque) in your arteries.

Just as chest pain (angina) on exertion is caused by a blocked heart artery, painful cramping in the calf, thigh or buttocks when walking – and which goes away at rest – is caused by blockages in the leg. This is called intermittent claudication.

Other PAD symptoms can include:

  • Feet that are cool to the touch
  • Leg or foot pain when lying flat that’s relieved by sitting
  • Loss of pulse in legs or feet
  • Redness, color changes in the skin
  • Shiny skin
  • Sores that do not heal (leg ulcers)
  • Gangrene

Notably, half of people with PAD have no symptoms at all, which is one reason why it’s so dangerous. PAD is a leading cause of amputation, and puts you at risk for heart attack, stroke and death.

How is peripheral artery disease treated?

Mild PAD may be effectively treated by quitting smoking, exercising regularly and eating a healthy diet. Certain medications also may be beneficial in managing symptoms.

Surgery is indicated when:

  • Medical management doesn’t improve your symptoms, or symptoms get worse despite medical management
  • Intermittent claudication interferes with your lifestyle or ability to work
  • Wounds won’t heal
  • There is infection or gangrene
  • You experience leg pain at rest due to lack of oxygen and nutrients to the leg
  • Amputation is a risk due to decreased blood flow

What does surgery for peripheral artery disease involve?

There are two procedures that involve the femoral-popliteal artery. The femoral artery starts in the lower abdomen and runs down into the thigh; when it reaches the back of the knee it becomes the popliteal artery. Its job is to supply oxygen-rich blood and nutrients to the lower extremities.

  • Femoral popliteal bypass (Fem-Pop bypass) – This is a surgical procedure used to treat severe blockage due to plaque in the femoral artery. This procedure is performed to bypass the blocked portion of the artery using a piece of another blood vessel (what’s called a vein graft). One end of the vein graft is attached above the blockage and the other end is attached below the blockage, rerouting blood flow around the blockage through the new graft. In some situations, a prosthetic graft (made of artificial material) may be used for the bypass graft.
  • Percutaneous transluminal angioplasty (PTA) of the femoral arteries This is a minimally invasive procedure used to open the blocked or narrowed femoral artery and restore blood flow to the lower leg without open surgery. A catheter (long hollow tube) with a tiny balloon at its tip is threaded up to the narrowing in the femoral artery under X-ray guidance. The balloon is inflated in the narrowed area of the artery, pushing the plaque to the side and widening the artery to improve blood flow. A stent (a tiny, expandable metal scaffold) may be placed the newly opened artery to prevent it from narrowing again.

Which procedure is right for me?

Each patient is unique, so your doctor will recommend the most appropriate treatment of your PAD based on careful evaluation of your individual situation. Both procedures require a hospital stay; how long depends on the procedure and your overall health.

Would you like to learn more about femoral popliteal bypass surgery or PTA in Portland? Please call us to schedule a consultation: (503) 607-8379.