Since the operation involves multiple cuts being made on the leg, this relatively high risk surgery involves several risks. Some complications are common for all types of leg associated surgery, while some are specific to popliteal bypass surgery. Complications include but not limited to the following: In the study of 6,007 people carried out popliteal bypass surgery, the overall rate of morbidity and mortality was 36.8% and 2.3% respectively within 30 days post-surgery. However, there are variations in studies of mortality as one particular study did not find any person deaths. The pre-existing risk factors in people can affect mortality rates, with common mortality factors being heart failure, myocardial infarction, diabetes mellitus, infection, and stroke. Infection Although antibiotics are generally given before and after surgery, people are still susceptible to wound infections and there is a 7.8% incidence of popliteal bypass surgery associated infections. Infection contraction is common in popliteal bypass surgery because of the poor blood circulation to the area, poor circulation means that the wounds will heal slower and the incision sites will have a higher chance of becoming infected. The infection of the vascular graft prosthesis occurs in every 1 in 500 people, under such circumstance the removal of the graft is needed. Graft infection is strongly associated with high morbidity and mortality. An obvious sign of a graft infection is the drainage of the sinus tract. Diabetes mellitus and redoing of the bypass graft are associated with a higher chance for graft infection. However, the reduction of graft infection frequency and complication can be brought by the advances in surgical techniques and graft design. Bleeding Occasionally, there may be leakage of fluid or blood from the incision wound, a study shows that 7.4 percent people are affected within 30 days post operation. However this normally settles in time and does not indicate a problem with the bypass itself. Heart problems People with peripheral artery disease undergoing popliteal bypass surgery are also more susceptible to myocardial infarction and abnormal heart rhythms, as patients requiring popliteal bypass are more likely to have higher cholesterol levels and higher blood pressure. The excess strain and damage caused by HBP and high cholesterol level can cause atherosclerosis. Over time, the coronary artery narrows and increases the patient's chance of getting a heart attack. Myocardial infarctions can also be caused by graft failure and hypoperfusion. Lymphedema The risk of lymphedema exists in 29 percent of patients, where leg swelling typically lasts 2 to 3 months. Lymphedema can be caused by blockages in the lymphatic system, leading to insufficient lymph drainage and fluid build-up in the leg. Though it is incurable, swelling of the leg is usually temporary. Treatment like compression stockings, meticulous skin care or doing remedial exercises may help ameliorate the symptoms. Amputation In rare situations when blockages severely disrupt or stop blood circulation, critical limb ischemia occurs. In cases of ischaemia, insufficient blood available for tissues to survive leads to gangrene and rest pain, in which case amputation is required. The major goals of amputation are to remove dead tissues, relieve pain and promote wound healing. Blood clots With surgery operations such as popliteal bypass, there will be an increased probability of blood clot formation. In rare cases, a part of the clot in the leg breaks free and travels to the lungs, this is also known as a pulmonary embolism. A blockage in the blood vessels of the lung can be formed by pulmonary embolism, and this could cause excess fluid build-up in the lung. This condition is also known as pulmonary edema, which is the excess fluid present in the lungs, more specifically, the accumulation of excess fluid in the air sacs of the lung, leading to the impairment of gas exchange and potentially respiratory failure. The incidence of early graft thrombosis is between 5-15% for popliteal bypass surgery. The cause of thrombosis is commonly due to technical errors of the surgery, other causes may include stenosis, narrow vein grafts, a low cardiac output and the compression of the graft. In such cases, heparin (anticoagulant) and thrombectomy can be used to treat graft thrombosis.
Femoropopliteal bypass
Vascular bypass
Vein stripping
Guillotine amputation
Revascularization
Distal Revascularization and Interval Ligation
Angioplasty
Fasciotomy