PVD/PAD collateral circulation vs femoral bypass?

[jlury]

Hi. My left leg femoral artery is blocked, but luckily good-ish collateral circulation has opened up so I can still be pretty active (claudication calf pain on walking fast). My vascular surgeon has advised me that there are risks with a bypass and therefore, assuming I still have good mobility, it is better not to do a bypass. However, I would like to be more active and therefore I want to understand more about the risks/benefits of having a femoral bypass done.
Does anybody have any experience of femoral bypass, good or bad?
Thanks in advance.

 

[Eddy Edson]

I'm in the same kind of situation. I also have a completely blocked left SFA but what seems to be really good collateral development which lets me walk 14K+ steps per day on average.

I do get fatigued and sometimes it hurts a lot (and I think I have some kind of ischemic neuropathy causing weakness and balance issues, under investigation at the moment). So I talked with my vascular surgeon about whether an intevention might make things better and did some digging around in the studies and treatment guidelines.

In brief, message is that there would be little reason in my case to expect that a bypass would be better than my current collateral network for blood flow. It wouldn't be additive - doing a bypass would screw up many of the collaterals. On the other hand, bypasses often fail over a short follow up period, so a clear risk of being left in a bad situation.

At least here in Oz (and I would guess in the UK too), I think generally they'll only recommend an intervention if there's limb-threatening critical ischemia.

 

[trophywench]

Oooh - they showed that very operation on TV this week! - the lady had already had a stent but artery was now blocked again, and her foot was dying. They had to first harvest a long vein from her then graft it onto the artery. Long operation, very delicate needlework. Numerous things which could go wrong even obtaining a long enough vein and sealing off all its peripherals so as to avoid leakage points.

I don't think they recommend it unless it's limb threatening either!

 

[jlury]

Thanks both - much appreciated.