From the Guidelines
Yes, it is normal to experience some inflammation and swelling along an axillary bifemoral bypass graft in the days to weeks following surgery. This is part of the body's natural healing response to surgical trauma. The inflammation typically peaks within the first week after surgery and should gradually decrease over the following weeks. You should monitor the area for signs of excessive swelling, increasing redness, warmth, severe pain, drainage, or fever above 101°F (38.3°C), as these could indicate an infection or other complications requiring immediate medical attention. During recovery, follow your surgeon's instructions regarding wound care, activity restrictions, and medication regimens. Most surgeons prescribe antibiotics to prevent infection and may recommend anti-inflammatory medications to manage pain and swelling. The inflammatory response occurs because the surgical procedure involves creating tunnels under the skin for the graft placement, which disrupts tissues and blood vessels, triggering the body's healing mechanisms. As healing progresses, the inflammation should steadily resolve, but complete resolution may take several weeks to months 1.
Some key points to consider:
- The prognosis of patients with vascular graft infections depends on many factors, including successful management of underlying comorbidities and risk factors, the microorganism that caused infection, and the extent of infection 1.
- Axillofemoral-femoral bypass is indicated for the treatment of patients with critical limb ischemia who have extensive aortoiliac disease and are not candidates for other types of intervention 1.
- Aortobifemoral bypass is recommended for patients with symptomatic, hemodynamically significant, aorto-bi-iliac disease requiring intervention 1.
- The expected patency of aortobifemoral bypass as the sole procedure for the treatment of critical limb ischemia is excellent, with a limb-based 5-year primary patency rate of 87.5% and a patient-based 5-year patency of 80.4% 1.
It is essential to note that while some inflammation and swelling are normal after axillary bifemoral bypass surgery, any signs of excessive or worsening symptoms should be promptly reported to the surgeon, as they may indicate complications such as infection or graft failure 1.
From the Research
Inflammation and Swelling after Axillary Bifemoral Bypass Graft Surgery
- Inflammation and swelling along an axillary bifemoral bypass graft after surgery can be a concern for patients and healthcare providers alike.
- According to the available studies, complications such as perigraft infection, intimal hyperplasia, and poor distal runoff can contribute to graft failure 2.
- However, the studies do not specifically address the normalcy of inflammation and swelling along the graft after surgery.
- A study on the management of failed and infected axillofemoral grafts notes that graft infection can result in a perioperative mortality rate of 22% and amputation in 57% of survivors 3.
- Another study on axillobifemoral bypass grafting mentions that the procedure is used to bypass a blockage in an occluded major vessel, but does not discuss post-surgical inflammation and swelling 4.
- A more recent study on axillary-bifemoral and axillary-unifemoral artery grafts reports similar perioperative outcomes and patency rates, but does not address inflammation and swelling specifically 5.
- An older study on axillofemoral bypass grafts notes that cumulative patency rates can be increased by thrombectomy, but does not discuss post-surgical inflammation and swelling 6.
Possible Complications
- Perigraft infection
- Intimal hyperplasia
- Poor distal runoff
- Graft thrombosis
- Anastomotic disruption
- Pseudoaneurysm formation
- Hemorrhage or graft rupture
Graft Patency and Outcomes
- Axillary-bifemoral and axillary-unifemoral artery grafts have similar perioperative outcomes and patency rates 5.
- Cumulative patency rates for Dacron axillobifemoral grafts were 97 +/- 3% at 32 months (73 +/- 21% at 42 months) 6.
- Patency in both unilateral and bifemoral grafts was significantly increased by thrombectomy 6.