Lower limb arterial bypass

Peripheral arterial disease is the narrowing or blockage of the leg arteries by atheroma. It first causes calf pain when walking, then, at an advanced stage, pain at rest, wounds that do not heal, or even gangrene. A bypass creates a new route for the blood by connecting the artery above the blockage to a healthy artery below it. The surgeon preferably uses one of the patient's own veins (often the saphenous vein in the leg), or a synthetic graft. Depending on the level of the disease, it may be an aorto-femoral, femoro-popliteal or distal (below-the-knee) bypass. A bypass is offered when the lesions are long or complex and cannot be treated with a balloon or stent, or when the leg is threatened. For simple discomfort when walking, medical treatment, stopping smoking and regular walking are always tried first. The team chooses between surgery, an endovascular technique or a combination of both, based on imaging. At Clinique Pasteur Tunis, bypass operations are carried out in the operating theatre by the vascular surgery team, with intra-operative imaging checks when needed and inpatient follow-up adapted to the cardiovascular conditions that often go with this disease.