• What is the problem ?
  
  
• What does the operation consist of ?
  
  
• What happens before the operation ?
  
  
• What happens after the operation ?

WHAT IS THE PROBLEM?

The main artery, which carries blood down your leg, is blocked just above the knee. The calf, foot and toes are starved of blood. This causes pain on walking. If you have pain at rest this can lead to serious infection and may be a sign of danger to the survival of you leg. We hope to open the blocked part of the artery with a balloon so that blood flows properly again.

WHAT DOES THE OPERATION CONSIST OF?

A needle is introduced into the main artery of the affected leg in the groin. A guidewire is passed down the artery and through the blocked part. A balloon is then introduced over the wire, through the block, and blown up to open up the artery. The blood will now flow on down the leg towards the toes.

WHAT HAPPENS BEFORE THE OPERATION?

Reception

When registering at reception your medical aid details will be required. If you are not on a member of a medical aid you will be required to pay a deposit or to sign an indemnity form. As far as possible we will try to advise you about hospital costs before your admission.

Welcome to the ward

You will be welcomed to the ward by the nurses or the receptionist and will have your details checked. Some basic tests will be done such as pulse, temperature, blood pressure and urine examination. You will be asked to hand in any medicines or drugs you may be taking, so that your drug treatment in hospital will be correct. Please tell the nurses of any allergies to drugs or dressings. The surgeon will have explained the operation and you will be asked to sign your consent for the operation. If you are not clear about any part of the operation, then read this again and then ask for more details from the surgeon or from the nurses.

Visit by the anaesthetist

If you are having a general anaesthetic, the anaesthetist who will be giving your anaesthetic will interview and examine you. He will be especially interested in chest troubles, dental treatment and any previous anaesthetics you have had.

Diet

You will have your usual diet until 6 hours before the operation when you will be asked to take nothing by mouth. This will let your stomach empty to prevent vomiting during the operation.

Shaving

The operation area will be shaved to remove excess hair.

Timing of the operation

The timing of your operation is usually arranged the day before so that the nurses will tell you when to expect to go to the operating theatre. Do not be surprised, however, if there are changes to the exact timing.

Transfer to theatre

You will be taken on a trolley to the operating suite by the staff. You will be wearing a cotton gown, wedding rings will be fastened with tape and removable dentures will be left on the ward. There will be several checks on your details on the way to the operating theatre where your anaesthetic will begin.

The operation is then performed.

WHAT HAPPENS AFTER THE OPERATION?

Coming round after the anaesthetic

If you have had an anaesthetic you will be conscious a minute or two after the operation ends,. You are, however, unlikely to remember anything until you are back in your bed on the ward. Some patients feel a bit sick for up to 24 hours after operation, but this passes off. You will be given some treatment for sickness if necessary. . You may be given oxygen from a face mask for a few hours if you have had chest problems in the past. You will be given salt solutions or blood down a plastic tube into an arm vein until you are drinking normally. Occasionally a tube (catheter) is put into your bladder to drain urine until you are more mobile.

If you have only had a local anaesthetic or epidural injection in your back you may still not remember much because of sedatives

Will it hurt?

There is discomfort on moving rather than severe pain. You will be given injections of tablets to control this as required. Ask for more if the pain is still unpleasant. You will be expected to get out of bed the day after operation. You will not do the wound any harm, and the exercise is very helpful for you.

Drinking and eating.

You should be able to eat and drink after your operation as you feel like.

Passing urine

If there is a drainage tube (catheter) in the bladder, passing urine is not a problem. Sometimes there is a feeling that there is a leakage all the time, but this is just an irritation by the tubing and it passes off. The catheter is taken out the morning after the operation. You must pass urine after the catheter is taken out. If you can't, ask the nurses for advice.

If you have not had a catheter it is important that you pass urine and empty your bladder within 6-12 hours of the operation. If you find using a bed pan or a bottle difficult, the nurses will assist you to commode or the toilet. If you still cannot pass urine let the nurses know and steps will be taken to correct the problem.

Sleeping

You will be offered painkillers rather than sleeping pills to help you to sleep. If you cannot sleep despite the painkillers please let the nurses know.

How long in hospital?

Usually you will feel fit enough to leave hospital the next day.

Sick notes

Please ask your surgeon for any sick notes or certificates that you may require.

After you leave hospital

You are likely to feel a bit tired and need rests 2 or 3 times a day for two weeks or more.

Driving

You can drive as soon as you can make an emergency stop without discomfort in the wound.

Complications

Early clotting of the opened artery is the main problem. It causes your symptoms to come back. A repeat procedure or bypass operation may then be needed. The major complication of operating on the arteries is limb loss . The risk of limb loss after a bypass is about 1%.

You MUST not smoke as this will make re-blockage of the artery almost certain.