What is femoral endarterectomy?

Femoral Endarterectomy
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Femoral endarterectomy: Overview

A femoral endarterectomy (say "FEM-uh-rull en-dar-tuh-REK-tuh-mee") is done to remove fatty buildup (plaque) from the femoral artery. This is a large blood vessel in the leg. When plaque builds up in the artery, it can make it hard for blood to flow in your leg. After surgery, blood may flow better in your leg. You may feel less leg pain. And you may have less numbness and cramping.

You may be asleep during the surgery. But it might be done while you are awake. If this is the case, you will get medicine to numb your leg and prevent pain.

The doctor will make a cut (incision) in your groin or upper thigh. The cut is made over the blocked part of the artery. The doctor will then make a cut in the artery and will take out the plaque.

Next, the doctor may sew a human-made patch over the cut in your artery. But sometimes a piece of blood vessel from another part of the leg is sewn over the cut. This will make the artery wider. It also helps keep it from getting narrow again. Then the doctor will close the cut in your skin. It will leave a scar. But the scar will fade with time.

You may spend at least 1 or 2 days in the hospital. You will need to take it easy for 1 to 4 weeks at home. It may take 6 to 8 weeks to fully recover.

How can you care for yourself after a femoral endarterectomy?

Activity

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Try to walk every day or as often as your doctor tells you. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
  • Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay. This may be for at least 1 or 2 weeks.
  • Ask your doctor when you can drive again.
  • You may need to take off 1 to 4 weeks from work. It depends on the type of work you do and how you feel.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • Eat heart-healthy foods. These include fruits, vegetables, and whole grains. If you have not been eating this way, talk to your doctor. You also may want to talk to a dietitian. This expert can help you learn about healthy foods and plan meals.
  • Drink plenty of fluids (unless your doctor tells you not to).
  • You may notice that your bowel movements are not regular right after your surgery. This is common. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
    • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
  • Your doctor may prescribe a blood thinner when you go home. This helps prevent blood clots. Be sure you get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems.

Incision care

  • If you have strips of tape on the cut (incision) the doctor made, leave the tape on for a week or until it falls off. Or follow your doctor's instructions for removing the tape.
  • You may shower as usual. Do not take a bath for the first 2 weeks or until your doctor tells you it is okay.
  • Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it oozes or rubs against clothing. Change the bandage every day.
  • Keep the area clean and dry.

How do you prepare for a femoral endarterectomy?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

After femoral endarterectomy: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have trouble breathing.

Call your doctor now or seek immediate medical care if:

  • You have sudden symptoms in your leg or foot such as severe pain, numbness, weakness, tingling, cool skin, or skin color changes. Your skin may be pale, bluish, or purplish.
  • You have pain that does not get better after you take pain medicine.
  • You have loose stitches, or your incision comes open.
  • You are bleeding a lot from the incision.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
  • You are sick to your stomach or cannot keep fluids down.

Watch closely for any changes in your health, and be sure to contact your doctor if:

  • You do not get better as expected.

After a femoral endarterectomy: Overview

You had a femoral endarterectomy (say "FEM-uh-rull en-dar-tuh-REK-tuh-mee"). It was done to remove fatty buildup (plaque) from the femoral artery.

You will have some pain from the cut (incision) the doctor made. This usually gets better after a couple of days. Your leg may be swollen at first. This may last at least a few weeks.

You will have stitches or staples in the incision. If you have stitches, they may dissolve on their own. Or your doctor may take them out 7 to 14 days after your surgery.

After surgery, blood may flow better throughout your leg, which can decrease leg pain, numbness, and cramping. You may be able to walk longer distances without leg pain.

You will likely have regular checkups with your doctor to check your arteries.

What happens on the day of a femoral endarterectomy?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.

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