Non-Invasive Peripheral Arterial Evaluation:
Bypass Grafts and Stents
What is an arterial bypass graft?
Surgical bypass treats your narrowed arteries by directly creating a detour, or bypass, around a section of the artery that is blocked. Your arteries are normally smooth and unobstructed on the inside but they can become blocked through a process called atherosclerosis, which means hardening of the arteries. As you age, a sticky substance called plaque can build up in the walls of your arteries. Cholesterol, calcium, and fibrous tissue make up the plaque. As more plaque builds up, your arteries can narrow and stiffen. Eventually, as the process progresses, your blood vessels can no longer supply the oxygen demands of your organs or muscles, and symptoms may develop.
During a bypass procedure, your vascular surgeon creates a new pathway for blood flow using a graft. A graft can be a portion of one of your veins or a man-made synthetic tube that your surgeon connects above and below a blockage to allow blood to pass through it and around the blockage.
You may be familiar with bypass surgery on heart arteries, but vascular surgeons also use similar bypasses to treat peripheral arterial disease (PAD). Surgeons use bypasses most commonly to treat leg artery disease, which is hardening of the arteries in the leg. Surgeons also use bypass to treat arm artery disease, as well as blockages involving blood vessels in other locations in the body.
What is a stent?
During an angioplasty, your vascular surgeon inflates a small balloon inside a narrowed blood vessel. The balloon helps to widen your blood vessel and improve blood flow. After widening the vessel with angioplasty, your vascular surgeon sometimes inserts a stent depending upon the circumstances. Stents are tiny metal mesh tubes that support your artery walls to keep your vessels wide open.
Angioplasty and stenting are usually done through a small puncture, or sometimes a small incision, in your skin, called the access site. Your vascular surgeon inserts a long, thin tube called a catheter through this access site. Using X-ray guidance, your physician then guides the catheter through your blood vessels to the blocked area. The tip of the catheter carries the angioplasty balloon or stent.
Angioplasty most often is used to treat peripheral arterial disease (PAD), which is another name for hardening of the arteries supplying blood to your limbs or to organs in your body other than your heart. Angioplasty can also be used, in some circumstances, to treat narrowed areas in your veins, which are blood vessels that drain blood out of your limbs or organs and return the blood to your lungs and heart.
Your arteries are normally smooth and unobstructed on the inside, but as you age, plaque can build up in the walls of your arteries. Cholesterol, calcium, and fibrous tissue make up this plaque. As more plaque builds up, your arteries can narrow and stiffen. This process is called atherosclerosis, or hardening of the arteries. Eventually, enough plaque builds up to reduce blood flow through your arteries causing pain or damage to the part of the body that the artery supplies.
Depending upon the particular circumstances, your physician may recommend angioplasty as an alternative to bypass surgery, which also treats narrowed arteries. For certain types of blockages, angioplasty has some advantages when compared to bypass surgery. For example, angioplasty does not require a large incision. Because of this, angioplasty patients usually spend less time in the hospital and recover at home faster than bypass surgery patients. Also, your physician can usually perform angioplasty while you are awake, whereas bypass surgery requires general or regional anesthesia. Nevertheless, in some circumstances, especially for extensive PAD, bypass surgery may be a better option. Your vascular surgeon will help you decide what alternative is best for your particular situation
What can I expect during the exam?
In addition to a complete duplex scan of the graft or stent and the inflow and outflow arteries, ankle and arm blood pressures will be measured using inflatable cuffs and an ultrasound Doppler flow detector.
A complete examination takes approximately 30 minutes. It is performed in a darkened room lying on an exam table. A technologist will place pressure cuffs on the arms, legs, and toes to perform the blood pressures of the extremities. For the arterial duplex exam, Images of the arteries will be taken using the ultrasound equipment. A transducer is placed on the extremity with a small amount of water soluble ultrasound gel.
- Allow 30 minutes for one arm or leg graft duplex study
- No smoking for at least an hour before the test.
- Please wear loose collar or button up shirt with short sleeves if your arms are to be examined.
- For leg studies, you will remove your pants, socks & shoes.
Please call us with questions or to schedule an appointment.