Femoral Endarterectomy

Arteries carry blood from the heart to all parts of the body. The femoral artery delivers blood to the thigh and lower leg. This artery is found in the groin area. It can become clogged with a fatty substance (plaque). This condition is called peripheral arterial disease. This can cause your leg to ache. It might feel cold or numb. It can also cause pain in the calf of your leg when you walk (claudication). When the femoral artery gets clogged, it needs to be cleaned out. Surgery to clean it out (endarterectomy) is needed.

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies to food or medicine.

  • Medicines taken, including vitamins, herbs, eyedrops, over-the-counter medicines, and creams.

  • Use of steroids (by mouth or creams).

  • Previous problems with anesthetics or numbing medicines.

  • History of bleeding problems or blood clots.

  • Previous surgery.

  • Other health problems, including diabetes and kidney problems.

  • Possibility of pregnancy, if this applies.

RISKS AND COMPLICATIONS

Problems usually do not develop after a femoral endarterectomy. However, possible risks include:

  • Bleeding that continues.

  • Infection.

  • Nerve damage.

  • Blood clots. These can form in the legs. Clots that break loose could travel to the heart, lungs, or brain.

  • Plaque can build up again, causing another blockage. This can happen months or years after your surgery.

BEFORE THE PROCEDURE

  • A medical evaluation will be done. This may include:

  • A physical examination. This includes questions about your overall health, today and in the past. Your blood pressure and heart rate will be checked.

  • Blood tests.

  • Doppler ultrasonography. This test uses sound waves to check blood flow through your femoral artery and leg.

  • Angiography. This is a type of X-ray. A dye is put in your blood so that it will show up on the X-ray.

  • Talking with an anesthesiologist. Usually, a medicine that will make you sleep (general anesthesia) is used. However, if spinal anesthesia is used, you will be numb from the waist down. You will be groggy but awake during the procedure. Ask your caregiver what to expect.

  • You may need to take medicine to prevent blood clots. Aspirin or blood thinners (anticoagulants) are used for this.

  • You will need to sign a legal paper that gives permission for the surgery (informed consent).

  • The day before the surgery, eat only a light dinner. Do not eat or drink anything for at least 6 hours before the surgery. Ask your caregiver if it is okay to take any needed medicines with a sip of water.

  • Arrive at least 1 hour before the surgery, or as told by your caregiver. This will give you time to check in and fill out any needed paperwork.

PROCEDURE

  • Small monitors will be placed on your body. They are used to check your heart, blood pressure, and oxygen level.

  • You will be given an intravenous (IV) line. Medicine will flow directly into your body through the IV.

  • If general anesthesia is used, a tube will be put in your throat. This helps you breathe during the surgery.

  • Your groin area will be cleaned with a germ-killing solution.

  • Once you are asleep, the surgeon will make a cut (incision) in the groin area above the femoral artery. The incision is usually a few inches long.

  • A clamp may be put on the artery above and below the blockage. This stops blood from flowing through the area.

  • The artery is cut open. The plaque is stripped away from the inner walls of the artery.

  • During the surgery, angiography may be done. This helps the surgeon tell how far the blockage goes. Later on, it can show whether all of the plaque is gone.

  • The artery will be closed. Then, the clamp is released. Blood can flow through the artery again.

  • The surgeon will close the incision. Staples or stitches will be used.

  • A bandage with medicine (dressing) will be placed over the incision.

AFTER THE PROCEDURE

  • You will stay in a recovery area until the anesthesia wears off. Your blood pressure and pulse will be checked. Then, you will be taken to a hospital room.

  • You may continue to get fluids through the IV for awhile.

  • Some pain is normal. You will probably be given pain medicine while in the recovery area. If your pain gets worse, be sure to tell your caregiver.

  • Angiography may be done again before you go home. This is to make sure the blood is flowing through the artery like it should.

  • Most people stay in the hospital for 1 or 2 days after this procedure.

HOME CARE INSTRUCTIONS

  • Take the medicines your caregiver has prescribed. Follow the directions carefully. Medicines may include blood thinners and pain medicine.

  • Do not take over-the-counter pain medicine unless your caregiver says it is okay.

  • Do not drive if you are taking narcotic pain medicines.

  • Keep the incision dry for a few days after surgery. Ask when it will be okay to take a shower. Do not take a tub bath for at least 2 weeks.

  • You will need to return to have your stitches (sutures) or staples taken out. This is usually done about a week after your surgery.

  • Walk. This is important. It will help keep blood clots from forming.

  • Go back to your normal routine slowly. Ask your caregiver if you have questions about a specific activity. Ask when it will be okay for you to drive.

  • Ask your caregiver when you can go back to work. This will depend on the type of work you do.

  • Do not smoke.

SEEK MEDICAL CARE IF:

  • You have any questions about medicines.

  • Pain continues, even after taking pain medicine.

  • You have pain or cramps in your leg while walking.

  • You have an oral temperature above 102° F (38.9° C).

SEEK IMMEDIATE MEDICAL CARE IF:

  • Pain gets much worse.

  • You have shortness of breath.

  • You have chest pain.

  • The area around the incision becomes red and swells.

  • Blood or other liquid leaks from the incision.

  • Your leg becomes red, swollen, or sore.

  • Your leg or foot changes color or becomes numb.

  • You have an oral temperature above 102° F (38.9° C), not controlled by medicine.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.