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Vascular Surgery/Question about bypass

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Question
Hello! First of all congrats! Your responses are so helpfull.

My man underwent a fempop bypass 8 months ago due to critical ischemia. He is doing well. Fortunately blood flow is normal again. Recently doctors found that the other leg is also total occluded but with an excellent collateral circulation and they believe surgery is not a need right now. As doctors say bypasses don't last forever so the later the do it the best for him and suggested walking as much as possible. He is 29 years old. What's your opinion?

Last but not least, I'd like to ask about grafts. How many popliteal bypasses can be done lifetime? What if after years there is a need for bypass redone or new bypass and there is no available saphenous graft?

He doesnt smoke anymore and has so other health problem such as diabetes or else. In both cases (leg and right leg) the problem caused by a thrombossed aneurysm. Do you believe a limb loss is still a possibility or sth that can be avoided?

Thanks for your response.

Answer
Hi, OMG I started your answer and then I lost the whole darn answer. Shoot
so let me take it from the top

the walking is important and works especially well hand in hand with massage
the crucial thing to remember is that the walk should take him TO the point of calf pain (claudication) but he should not walk TRHU the pain, when he starts getting claudication, he should stop and let the blood flow fill the leg arteries  (gravity dies this trick all on its own, just stopping the walk will allow the vessels to refill and stop the pain. once he feels good again, start walking and when the pain starts, stop til it's gone....over and over.

massage, even just during daily bath or shower also increases the blood flow to the vessels and increases collateral circulation, doesn't have to be fancy massage, just stimulating the muscles nerves and blood vessels

if, when and if he needs another bypass, you are right natural saphenous vein is the longest lasting but there are synthetic grafts, and cadaver grafts....remember surgery does not cure the disease or remove the blockage, it is more of a road detour.

The lifespan of a surgical bypass depends on the health of his arteries, the type of graft used (natural vein grafts last longer than synthetic ones) and other health factors, such as whether he is smoking, develops another problem such as diabetes, heart or kidney issues

I hope this helps, take care and best of luck, lauri

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Lauri Ordway

Expertise

I can answer your questions related to your circulation, your peripheral vascular system. This includes all arteries and veins except those inside the head and inside the heart. For example, neck (carotid), arms (carotid subclavian bypasses to Thoracic Outlet) belly (aortic aneurysm & occlusive disorders, renal artery stenosis), legs (iliac, femoral, popliteal, peroneal, dorasalis pedis, posterior and anterior tibial) arteries. Aneurysm & occlusive disease, atherosclerosis, leg pain, arterial wounds and gangrene, amputation prevention. Arterial Bypass, Reynaud’s, Buerger's disease (thromboangiitis obliterans), Thoracic Outlet and other circulation disorders. Vein disorders: Blood Clots (DVT), post-phlebetic syndrome, varicose veins, venous stasis ulcers. I can help with vascular wounds from diagnosis to treatments. I have worked extensively with VNUS Closure and EVLT (Laser) for varicose veins and can describe pre and post procedure expectations and describe the procedures themselves. I can't help with spider veins or cosmetic vein treatment, we don't do it. I have 15 years of wound care experience, arterial, venous, trauma and diabetic wounds for example. **I CANNOT answer questions about STENTS or STENTING, heart disease, blood pressure, brain aneurysm although I can help with questions about the arteries that go to and from those organs.

Experience

I am a nurse, I worked for 15 years with two terrific peripheral vascular surgeons, and one of them is also the inventor of very innovative wound care products and surgical instruments to make vascular surgery procedures better and faster. I wrote and manage the clinic website and field questions from patients all over the world. I am now working with another vascular surgeon and wound care expert, which has given me an opportunity to widen my horizons as I learn another excellent physician's preferences and benefit from his experiences in this amazing specialty.

Education/Credentials
I am an LPN, licensed in Minnesota

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