Peripheral Arterial Disease

The area  of disease that a femoral popliteal bypass focuses on is peripheral arterial disease (PAD), this disease causes a build-up of deposits within the patient's' arteries causing a narrowing or blockage reducing or even stopping circulation to the rest of the limb (NHS. 2023).  Complications of PAD include chronic limb ischemia, chronic pain, cardiovascular events such as a myocardial infarction (MI), tissue loss and even loss of limb (Bhagirath et al. 2022).   

Image:(Heart research institute , 2024)

PAD is becoming a worldwide concern with Nordanstig et al. (2023) finding that from 2000-2010 cases of PAD increased by 200 million worldwide. In the United Kingdom up to 20% of the population over the age of 60 have PAD according to NICE. (2024) in 2022 the national vascular report by Waton et al. (2022) found in 2021 that 12,326 surgical procedures were performed to treat PAD via open or closed (Endovascular) approaches.   

Image:(English Diabetes footcare network, 2024)

Complications

Chronic limb ischemia is a major complication of PAD occurring in 5%-10% of people who are diagnosed with PAD. Mortality rates for PAD in the UK are between 15% and 20% after revascularisation of the limb (NICE. 2024). The cost of this to the National Health Service (NHS) is estimated by Dardik. (2016) to be £200 million a year.

Furthermore, the longer PAD is left untreated or undiagnosed the greater the risk to the patient, including worsening pain, limiting mobility, ulceration and an increased  risk of amputation. (Sareen and Ojha. 2018). The risk of amputation for diabetic patients is even higher, as discussed by Jude et al. (2010) due to increased rates of ulceration and if revascularisation is not attempted early can lead to infection and ultimately amputation.

Image:(USA Vascular Centre , 2023)