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.
vignette|upright=0.6|Exemple de chirurgie vasculaire: retrait d'une plaque d'athérome dans la carotide. La chirurgie vasculaire est la chirurgie des vaisseaux, artères et veines, à l'exclusion des vaisseaux intracrâniens et coronaires. Chirurgie artérielle Traite non seulement les occlusions artérielles aiguës (ischémie aigüe de membre) et chroniques (artériopathie oblitérante), les anévrismes artériels, les dissections artérielles (dissection aortique de type B) mais aussi les traumatismes artériels (plaies graves chez les polytraumatisés), les malformations arterio-veineuses, créé des fistules arterio-veineuses (accès pour hémodialyse), assiste sur les transplantations d’organes lors de gestes sur les vaisseaux compliqués.
L'athérectomie est une intervention chirurgicale qui consiste à diminuer voire éliminer les plaques d'athérome qui obstruent une artère lors d'une artériographie et plus particulièrement lors d'une coronarographie. L'athérectomie est un terme générique désignant un ensemble de méthodes dont l'objectif est de rouvrir les artères bouchées en meulant ou en retirant la plaque d'athérome qui s'y est accumulée. Ce sont les conséquences de l'athérosclérose.
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