Mr. Venu Bhamidi is a vascular surgeon in Auckland whose practice involves all treatment of all aspects of arterial disease, including claudication.
Leg bypass surgery is a procedure used to treat peripheral arterial disease caused by accumulation of plaque. Plaque build-up occurs due to several risk factors such as smoking, diabetes, high blood pressure, high cholesterol, family history of artery problems, and increasing age to name a few. Blockages in the artery typically cause leg pain when walking or exercises due to lack of blood supply to the muscles, known as intermittent claudication. Claudication usually starts with exercises and is relieved with rest. If the blood supply becomes critical, other symptoms may include numbness and tingling sensation in the feet, pain in the foot at night-time, ulcers/wounds or gangrene.
How are blockages and claudication treated?
If the blockage in the artery is short in length, it may be possible to have the blockage opened up with angioplasty (balloon and/or stent techniques) however if the blockage is long, the better option may be to bypass the blockage (most often the femoral or popliteal artery) using either a vein from the patient’s leg or a synthetic graft. The femoral and popliteal arteries are the major arteries in the leg that are most often affected by plaque build-up. If the blockage is above the level of the groin, a bypass may involve a cut in both groins (femoro-femoro crossover) or in the abdomen (aorto-femoral bypass) to allow more blood flow into the groin and down the leg.
Where possible, Mr. Bhamidi prefers to avoid major leg surgery and treats narrowings or blockages in the legs and claudication using angioplasty and/or stents (minimally invasive keyhole techniques). However, not all blockages can be easily fixed with minimally invasive techniques and this is where bypass surgery is beneficial. The decision about bypass or angioplasty will be made in consultation with you after you have had scans to see exactly where and how bad the blockage is.