Venous Bypass Surgery

Venous bypass is surgery that improves the blood flow through your veins.

Your doctor will use a healthy vein to make a new path around the part of your vein that isn't working. Your doctor may suggest a vein bypass if you have:

• A blood clot.
• Any other type of blockage in your veins.
• Scar tissue.

UPMC surgeons have extensive experience performing cardiovascular surgery. If you need a venous bypass, our doctors will determine the correct treatment option for your condition.

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What Is Venous Bypass Surgery?

Venous bypass surgery reroutes blood flow by bypassing a blocked area. Your doctor creates a new path around the blockage using a healthy vein from your arm or leg or a synthetic alternative. Your doctor may recommend this procedure if you have a blood clot, scar tissue, or other blockage.

Venous bypass restores blood flow and keeps tissue alive, helping to avoid further complications or amputation.

Venous bypass surgery is performed less frequently as endovascular (minimally invasive) techniques are becoming more common.

Conditions we treat with venous bypass surgery

Venous bypass surgery treats venous disease, which occurs when the valves in your veins don’t work properly, preventing proper blood flow.

Your veins carry blood to your heart, and when they become damaged, your heart starts to weaken.

For people with venous disease, blood often builds up in the legs. This puts pressure on the veins in your legs and causes other problems, such as pain and swelling.

Why Would I Need Venous Bypass Surgery?

Your doctor may suggest a venous bypass if you have:

• A blood clot.
• Any other type of blockage in your veins.
• Scar tissue.

Venous bypass surgery has a short-term success rate of 90–95 percent. Long-term success depends on several factors, including your general health and the quality of the veins or synthetic material used for the bypass graft.

Who’s a candidate for venous bypass surgery?

You may be a candidate for venous bypass surgery if you have a vein or veins blocked by blood clots, scar tissue, or another obstruction. This surgery is appropriate for people who have:

• Venous disease.
• Atherosclerosis.
• Peripheral arterial disease (PAD).

Alternatives to venous bypass surgery

Angioplasty is a non-invasive alternative to bypass surgery that threads a catheter through the vein to the blockage and uses a stent to keep the vein open and increase blood flow.

What Are the Risks and Complications of Venous Bypass Surgery?

As with any surgery, venous bypass carries some risks and complications. After assessing your condition, your doctor will discuss possible risks based on:

• Your age.
• The stage of venous disease.
• Your past health history.

Make sure you ask questions if you have any concerns.

You may have an increased risk for post-op complications if you have:

• High blood pressure.
• Diabetes.
• DVT or other clotting disorder.
• A history of smoking.

Complications can include:

• Bleeding or blood clots.
• Infection.
• Nerve damage.
• Minimal swelling.

What Should I Expect From Venous Bypass Surgery?

Before: How to prepare for venous bypass surgery

You may need some tests before venous bypass surgery, such as:

• Electrocardiogram (ECG or EKG) — This test records the electrical activity of your heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and can sometimes detect heart muscle damage.
• Chest x-ray — A chest x-ray is a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. An x-ray can show enlargement in any area of the heart.
• Ultrasound — Traditional ultrasound uses sound waves that bounce off tissues to create images.

Your doctor will explain the venous bypass procedure to you and give you a chance to ask questions. To prepare for the procedure, you should:

• Tell your doctor if you are sensitive or allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
• Tell your doctor about all medications (prescription and over-the-counter) and herbal or other supplements you are taking.
• Tell your doctor if you have heart valve disease. You may need to receive an antibiotic before the procedure.
• Tell your doctor if you have a history of bleeding disorders or if you are taking any blood-thinning medications, aspirin, or other medications that affect blood clotting. You may need to stop some of the medications prior to the procedure.
• Fast for a certain time before the procedure. Your doctor will tell you how long to fast (usually overnight).
• Have any tests that your doctor recommends. For example, your doctor may request a blood test prior to the procedure to determine how long it takes your blood to clot.

On the day of your venous bypass procedure, be sure to bring your photo ID and health insurance card(s). Leave valuables such as cash and jewelry at home.

After your venous bypass procedure, you will stay in the hospital for several nights. Your doctor will let you know how many nights may expect to stay for the type of procedure you are having.

You should bring toiletries, a robe, slippers, a cell phone and charger, medications, and a change of clothes. You should also arrange for someone to drive you home from the hospital after you are discharged.

How long does venous bypass surgery take?

Venous bypass surgery is a major surgery that takes 2-6 hours. You will need to stay in the hospital for 3 to 10 days (about 1 and a half weeks) after surgery.

During your venous bypass surgery

You will be under general anesthesia during surgery, so you will be asleep and won't feel any pain.

To create the bypass, your surgeon will:

• Find a healthy vein from somewhere in your body or use a graft.
• Make a small cut in the blocked vein.
• Sew the vein or graft from either side of the blockage to restore blood flow.

Depending on the severity and location of your blockage, the procedure can take a few hours. After the bypass is complete, your surgeon will close your incision.

Recovery after your venous bypass surgery

After bypass surgery, you will need to stay in the hospital for 3-10 days. Your doctor will want to watch your condition and ensure you have no complications from the surgery.

Before you go home, your doctor may prescribe medicine to prevent future blood clots or physical therapy to help with your recovery.

It generally takes 6 to 12 weeks (about 3 months) to fully recover and return to normal activities. You will need regular checkups with your doctor to ensure the graft is working.

When to call your doctor about venous bypass complications

You may have an increased risk for post-op complications if you have:

• High blood pressure.
• Diabetes.
• DVT or other clotting disorder.
• A history of smoking.

Complications can include:

• Bleeding or blood clots.
• Infection.
• Nerve damage.
• Minimal swelling.

If you have any of these post-surgery issues, contact your doctor immediately.

What’s the success rate of venous bypass surgery?

Sixty to 85 percent of bypasses remain open five years after surgery.

Why Choose UPMC for Venous Bypass Surgery?

When you choose UPMC for venous bypass surgery, you will benefit from:

• Our coordinated treatment approach. Our team of endovascular and vascular surgeons works closely with other specialists to ensure complete care.
• Our vascular surgeons. As specialists in therapies for vascular disease, our vascular surgeons have outstanding results.
• Our experience. Our experts perform hundreds of minimally invasive and surgical procedures to treat vascular disease annually. UPMC is also a major referral center for people with complex vascular conditions.

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By UPMC Editorial Staff. Last reviewed on 2024-10-01.