Peripheral Artery Disease (PAD) Surgery

If you have peripheral artery disease (PAD) that hasn’t responded to medical management and lifestyle changes, or symptoms such as leg pain or a wound that won’t heal, your doctor may recommend surgical treatment. The goal of surgery is to help your blood flow more easily to your extremities — most commonly your legs.

Surgical treatment improves blood flow by treating the narrowing or blockages of the leg (femoral) artery. This can:

• Relieve symptoms
• Enable a normal lifestyle
• Reduce the risk of more serious problems

Our surgeons have extensive experience in treating PAD. These treatments include the two most advanced approaches:

• Percutaneous transluminal angioplasty (PTA) of the femoral arteries
• Femoral popliteal (fem-pop) bypass graft

How is peripheral artery disease treated?

Mild PAD may be effectively treated by quitting smoking, exercising regularly and eating a healthy diet. Certain medications also may be beneficial in managing symptoms.

Surgery is indicated when:

• Medical management doesn’t improve your symptoms or symptoms get worse despite medical management.
• Exercise-related leg pain (Intermittent claudication) interferes with your lifestyle or ability to work.
• Wounds won’t heal.
• Infection or gangrene form.
• Leg pain occurs at rest due to lack of oxygen and nutrients to the leg.
• Decreased blood flow is risking amputation.

Fem-Pop and PTA for peripheral artery disease

The femoral artery starts in the lower abdomen and runs down into the thigh. When it reaches the back of the knee, it becomes the popliteal artery. It brings oxygen-rich blood and nutrients to the lower leg.

When this artery becomes narrowed or blocked by PAD, surgery can help. Options include:

Percutaneous transluminal angioplasty (PTA) of the femoral arteries: This is a minimally invasive procedure used to open the blocked or narrowed femoral artery and restore blood flow to the lower leg without open surgery. Using X-ray guidance, the surgeon threads a catheter (a thin, hollow tube) to where the artery is narrowed. Then the narrowing or blockage can be opened either by using lasers or by inflating a tiny balloon at the tip of the catheter. Either method widens the artery to improve blood flow. A stent (a tiny, expandable metal mesh) may be placed the newly opened artery to keep it from narrowing again.

Femoral popliteal (fem-pop) bypass: This is an open surgical procedure to treat severe blockage due to plaque in the femoral artery. An incision in the leg gives the surgeon access to the narrow part of the artery. A piece of another blood vessel (called a vein graft) creates a detour for the blood to flow around the blocked part of the artery. In some situations, a graft of artificial material may be used for the bypass.

Both procedures require a hospital stay. Stays vary based on the procedure and the patient’s overall health.

Which PAD surgery is right for me?

Each patient is unique. After a careful evaluation of your individual symptoms and condition, we will discuss the most appropriate treatment of your PAD.

To learn more or schedule an appointment with our vascular team in Portland, call 503-256-1575.