A vascular bypass is a surgical procedure performed to redirect blood flow from one area to another by reconnecting blood vessels. Often, this is done to bypass around a diseased artery, from an area of normal blood flow to another relatively normal area. It is commonly performed due to inadequate blood flow (ischemia) caused by atherosclerosis, as a part of organ transplantation, or for vascular access in hemodialysis. In general, someone's own vein (autograft) is the preferred graft material (or conduit) for a vascular bypass, but other types of grafts such as polytetrafluoroethylene (Teflon), polyethylene terephthalate (Dacron), or a different person's vein (allograft) are also commonly used. Arteries can also serve as vascular grafts. A surgeon sews the graft to the source and target vessels by hand using surgical suture, creating a surgical anastomosis.
Common bypass sites include the heart (coronary artery bypass surgery) to treat coronary artery disease, and the legs, where lower extremity bypass surgery is used to treat peripheral vascular disease.
Coronary artery bypass surgery
Cardiac bypass is performed when the arteries that bring blood to the heart muscle (coronary arteries) become clogged by plaque. Such a condition may cause chest pain from angina pectoris or a heart attack. Dimensional aspects, material selection, and manufacturing methods influence mechanistic behaviours of artificial grafts and chosen to receive artery-like behaviour
Popliteal bypass surgery
In the legs, bypass grafting is used to treat peripheral vascular disease, acute limb ischemia, aneurysms and trauma. While there are many anatomical arrangements for vascular bypass grafts in the lower extremities depending on the location of the disease, the principle is the same: to restore blood flow to an area without normal flow.
For example, a femoral-popliteal bypass ("fem-pop") might be used if the femoral artery is occluded. A fem-pop bypass may refer to the above- or below-knee popliteal artery.
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Chronic limb threatening ischemia (CLTI), also known as critical limb ischemia (CLI), is an advanced stage of peripheral artery disease (PAD). It is defined as ischemic rest pain, arterial insufficiency ulcers, and gangrene. The latter two conditions are jointly referred to as tissue loss, reflecting the development of surface damage to the limb tissue due to the most severe stage of ischemia.
Vascular surgery is a surgical subspecialty in which vascular diseases involving the arteries, veins, or lymphatic vessels, are managed by medical therapy, minimally-invasive catheter procedures and surgical reconstruction. The specialty evolved from general and cardiovascular surgery where it refined the management of just the vessels, no longer treating the heart or other organs. Modern vascular surgery includes open surgery techniques, endovascular (minimally invasive) techniques and medical management of vascular diseases - unlike the parent specialities.
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