Vascular Bypass Surgery & Angioplasty
- Why this surgery?
Your surgery was designed to bring additional blood supply to the area of lower limb/ upper limb, where it was deprived of blood before. This deprivation was due to the narrowing of the arteries supplying the muscle.
- Vascular Bypass Surgery
A vein from your leg/arm or an artificial graft is used to bypass (go around) the blockage of the artery. The removal of the vein from the leg is not harmful. If a vein cannot be used for the bypass, an artificial graft is used. One end of the vein is attached to the artery above the blockage and the other end is fixed below the blockage.
A balloon catheter is pushed up to the affected area. The balloon is then inflated to break up the hard plaque. In case, the artery has lost its elasticity and does not remain open after balloon angioplasty, the doctor places a stent. A stent is a tube metal wire to provide support to the blood vessel walls.
Foot pain while taking rest and pain in the legs while walking are due to the insufficient blood flow. Angioplasty significantly improves the blood flow and diminishes the pain. Even the wounds heal remarkably well.
- Please follow these, to Get Well soon:
- 1 . Activity:
You have made a good recovery from the surgery and you are ready to go home. You may get tired easily and may want to rest down between activities. This is normal. However, your strength will return steadily within a few months. Regular exercise is very important.
WALKING promotes blood flow, tones the muscles, and makes you feel fit too. You need to increase your pace and length slowly. You can start off with 5-10 minutes a day. You can climb the stairs, but avoid bending the knee too much (not above90*), if graft is placed across it.
Always try to keep your legs straight.
Do not sit cross legged and do not squat.
Lifting weights should be avoided for 6-8 weeks post surgery. If you have a foot ulcer wear an appropriate foot wear prescribed by the doctor and walk with the help of walker only. Absolutely avoid putting weight on the part of the foot ulcer while walking.
- 2 . Driving:
It is NOT ADVISABLE to drive for a few weeks. You may start driving, when you are free to move your legs comfortably and are free of pain.
- 3 . Returning To Work:
Adequate rest or -3 weeks is advised. If you have undergone angioplasty and stent 1-2 weeks rest is sufficient. You may resume your work once you regain your strength.
- 4 . Diet:
Loss of appetite and constipation may occur. It should return to normal within a few weeks. Eat a balanced diet. If you are constipated increase intake of fibre and fluids. Raw fruits, bran products, vegetables are rich in fibre. Drink 6-8 glasses of water every day. (Unless your fluid intake is restricted due to any other medical illness).
- 5 . Wound Care:
The incisions over the limbs / abdomen are made during surgery. There will be pins put for skin closure at the operation site; there may be mild swelling and discomfort in the area of the incision for some days. This will gradually disappear. Continue crepe bandage application snugly over the legs, until the swelling is reduced. There may also be some numbness of skin on either side of incisions. If you notice unusual swelling and pain inform doctor. These clips will be removed after two weeks at vascular OPD.
- 6 . Prevention Of Pressure Sores:
Keep your legs straight, whenever you sit or lie down flat. Keep a pillow under your legs, heel should be outside the pillow. This needs to be practiced before and after the surgery. This is to avoid the risk of developing an ulcer on the heel; as this may worsen the condition. Also keep changing your position frequently. Observe if there are any skin changes on the pressure areas like heel or lower back. This is an important way to protect yourself from injury.
- 7 . Clothing:
Do not wear tight clothes such as tight socks / pants, tight foot wear as they can restrict the leg/ feet.
- 8 . Foot Care & Foot Wear:
Care of the skin of the feet and legs is very important. Wash clean and pat dry your feet every day. Protect your feet from extreme temperatures. Do not walk bare foot. Appropriate foot care education and foot wear will be provided by the Podiatrist. If you have an ulcer or wound, everyday dressing is required. While walking, w ear proper footwear given to you by your podiatrist.
- 9 . Medication:
Take medicines as advised by doctor. Purpose and effects of drugs will be discussed with you by the doctor.
- 10 . Prevention Of Infection:
If you have an artificial graft, take good precautions to avoid infection of the graft. Take your temperature if you feel feverish. Inform your doctor if it exceeds 100*F.
- 11 . Reducing Risk Factors :
1. Fat deposits in the artery (atherosclerosis) can be reduced if you improve your quality of life. Impart healthy life changes.
2. Control Hypertension, Diabetes and High Blood Cholesterol.
3. Stop Smoking.
4. Exercise regularly.
5. Reduce stress in your life.
6. Modify your diet to low cholesterol and sugars.
7. Smoking: Nicotine in cigarettes causes the arteries to narrow and thus decreasing blood flow. This speeds up the heart rate and increases blood pressure. Complete smoking cessation is advised.
8. Alcohol intake should be in moderation.
- 12 . Follow Up Care:
If you are diabetic or have blood pressure, continue with your physician’s prescribed treatment. Regular blood tests for sugar and lipids are advised. Regular follow ups to your vascular doctors, with prior appointments, are a must. Do inform your doctors if any of the following occurs:
1. Changes in incision – unusual discharge or bleeding
2. Fever above 100*F
3. Increased pain 4. Loss of sensation/ movement of toes
5. Coldness of feet / hand