Infrainguinal bypass

Complications of femoropopliteal and femorotibial arterial reconstructions occurring in the immediate postoperative period are likely to be technical errors. Thrombosis of the graft is signaled by the loss of distal pulses compared with findings at the completion of the procedure. Doppler evaluation at regular intervals may detect impending graft failure. Other signs of a failed graft include recurrent limb pain, parasthesias, paralysis, pallor, and a cool extremity. Operative intervention should be undertaken immediately.

Significant hemorrhage following femoral bypass surgery is uncommon, but may indicate technical errors at the anastamosis, in the graft tunnel, or in the graft itself, such as a non-ligated venous branch. These mechanical failures should be addressed in the operating room once the patient is stabilized, although direct pressure can be applied as needed until that time.

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