Aortoiliac Bypass
What is Aortoiliac Bypass?
Aortoiliac bypass is a surgical procedure to bypass blockages in the aorta or iliac arteries using a graft, restoring blood flow to the pelvis and legs. It’s typically performed for severe aortoiliac occlusive disease (AIOD), a form of peripheral artery disease (PAD), when less invasive options like angioplasty are unsuitable. In India, this procedure is performed in vascular surgery departments at hospitals like Apollo, Fortis, Medanta, and AIIMS, often at affordable costs. Understanding the procedure, costs, recovery, risks, and FAQs is essential for patients.
Why do you need Aortoiliac Bypass?
Aortoiliac bypass is indicated for:
- Aortoiliac occlusive disease (AIOD):
- Severe blockages in the aorta or iliac arteries due to atherosclerosis.
- Symptoms: Claudication (leg pain on walking), rest pain, non-healing ulcers, or gangrene (critical limb ischemia, CLI).
- Prevalence in India: PAD affects 5–10% of adults over 50; AIOD is 20–30% of PAD cases; higher in diabetics and smokers.
- Other indications:
- Failed endovascular treatment (e.g., angioplasty/stenting; 20–30% failure rate in complex AIOD).
- Aortoiliac aneurysm (if combined with occlusion; rare, addressed differently).
- Types:
- Aortobifemoral bypass: Most common; graft from aorta to femoral arteries (both legs).
- Aortoiliac bypass: Graft from aorta to iliac arteries (less extensive).
- Axillobifemoral bypass: Alternative (extra-anatomic); graft from axillary to femoral arteries (if aorta unsuitable).
- Associated treatments:
- Pre-op: Antiplatelets (e.g., aspirin), statins to manage cholesterol.
- Post-op: Anticoagulation (e.g., heparin initially), lifelong aspirin, and lifestyle changes.
- Timing:
- Performed in adults (average age 50–70 years for PAD); urgent for CLI (rest pain, ulcers).
The procedure aims to relieve leg pain, heal ulcers, and prevent amputation, with a high success rate for limb salvage in severe cases.
Why Do Aortoiliac Bypass Costs Vary in India?
Costs range from ₹2 lakh to ₹5 lakh:
- Procedure Complexity: Aortoiliac (₹2–3 lakh); aortobifemoral (₹3–5 lakh); axillobifemoral (₹2.5–4 lakh).
- Graft Type: Synthetic (Dacron/PTFE, ₹50,000–₹1 lakh); costlier for longer grafts.
- Hospital/Location: Higher in metro cities (Apollo, Fortis: ₹3–5 lakh); lower in government hospitals (AIIMS: ₹1–2 lakh, often subsidized under Ayushman Bharat).
- Surgeon’s Expertise: Experienced vascular surgeons charge more.
- Additional Costs: Anesthesia (₹20,000–₹40,000), hospital stay (₹5,000–₹15,000/day), imaging (₹10,000–₹20,000), medications (₹10,000–₹20,000).
- Insurance: Often covered (medical necessity); confirm with your provider.
Aortoiliac Bypass Procedure
- Before Surgery Evaluation:
- Assessment:
- Imaging: CT angiography or MR angiography to map blockages (e.g., >90% stenosis in iliac artery).
- Ankle-brachial index (ABI): Measures blood flow (normal 0.9–1.3; <0.5 indicates CLI).
- Blood tests: Kidney function (creatinine), blood sugar (diabetes control), clotting profile.
- Doppler ultrasound: Assesses distal runoff (blood flow below blockage).
- Preparation: Optimize diabetes, stop smoking, stop blood thinners (if safe); fasting 6–8 hours.
- Consent: Risks, including graft occlusion, are explained.
- Assessment:
- Surgical Technique:
- Aortoiliac Bypass (Aortobifemoral):
- Performed under general anesthesia, lasting 3–5 hours.
- Process:
- Incision: Midline abdominal (10–15 cm) to access aorta; groin incisions (5–7 cm) for femoral arteries.
- Aorta and iliac/femoral arteries exposed; aorta clamped above and below blockage.
- Synthetic graft (e.g., Dacron or PTFE, Y-shaped) sewn to aorta (end-to-end or end-to-side) and femoral arteries.
- Blood flow restored; clamps removed; graft patency confirmed (e.g., palpable pulses).
- Closure: Sutures in layers; drains placed (removed in 1–2 days).
- Alternative Approaches:
- Laparoscopic: Less common; smaller incisions, longer operating time.
- Axillobifemoral: Extra-anatomic; used if aorta diseased or patient high-risk.
- Intraoperative Tools:
- Vascular clamps: Control blood flow.
- Doppler probe: Confirms distal pulses post-bypass.
- Heparin: Prevents clotting during surgery.
- Aortoiliac Bypass (Aortobifemoral):
- After Surgery:
- Hospital stay: 5–7 days.
- Care: Monitor pulses, wound care; early ambulation (day 1–2) to prevent clots; drains removed in 1–2 days.
- Pain management: Moderate pain for 3–5 days (abdominal/groin incisions); managed with painkillers (e.g., tramadol).
- Instructions: Avoid heavy lifting for 6–8 weeks; start aspirin and statins immediately.
Recovery After Aortoiliac Bypass
- Hospital Stay: 5–7 days.
- Post-Surgery Care:
- Pain: Moderate pain for 3–5 days (incisions); resolves in 1–2 weeks.
- Activity: Avoid strenuous activity for 6–8 weeks; light walking encouraged day 1–2 to prevent clots.
- Incision: Abdominal scar (10–15 cm) and groin scars (5–7 cm) fade in 6–12 months.
- Symptoms: Claudication relief in 80–90% within weeks; ulcers heal in 4–12 weeks (CLI cases).
- Medications: Lifelong aspirin, statins; short-term heparin or low-molecular-weight heparin (LMWH).
- Follow-Up:
- Visits at 1 week (check wounds), 1 month, and every 3–6 months (monitor graft patency).
- Imaging: Doppler ultrasound at 1–3 months; 85–90% graft patency at 5 years (aortobifemoral).
Most resume normal activities in 4–6 weeks; full recovery takes 2–3 months. Success rate: 85–90% limb salvage in CLI; 90–95% symptom relief; 5-year graft patency 85–90% (aortobifemoral).
Risks and Complications
- Surgical Risks:
- Bleeding (3–5%): During surgery; may need transfusion (1–2%).
- Infection (2–5%): Graft or wound; may need antibiotics or graft removal (rare, <1%).
- Anesthesia risks (<1%): Reaction to anesthesia; higher in elderly or comorbid patients.
- Post-Surgery:
- Graft occlusion (5–10% at 5 years): Clot in graft; may need reoperation or endovascular intervention.
- Limb ischemia (1–3%): Distal clot; may lead to amputation (<1% with good runoff).
- Bowel/sexual dysfunction (1–2%): Rare; from nerve injury during aortic dissection.
- Incisional hernia (5–10%): At abdominal site; may need repair.
- Long-Term:
- Graft infection (1–2%): Late onset; may need graft removal (devastating).
- Progression of PAD (20–30%): New blockages elsewhere; managed with lifestyle changes, medications.
Report fever, severe leg pain, cold/pale limb, or wound redness promptly.
Frequently Asked Questions (FAQs)
What causes the need for aortoiliac bypass?
Aortoiliac occlusive disease (AIOD) from atherosclerosis, causing leg pain, ulcers, or gangrene.
Can I avoid aortoiliac bypass?
Yes, if less severe: Angioplasty/stenting (as in your prior query); bypass needed for extensive blockages or failed endovascular treatment.
Is aortoiliac bypass painful?
Moderate pain for 3–5 days (incisions); managed with medication; resolves in 1–2 weeks.
How soon can I resume normal activities?
Light activities: 2–3 weeks; full recovery: 2–3 months; avoid strenuous activity for 6–8 weeks.
Is aortoiliac bypass covered by insurance in India?
Often covered (medical necessity); confirm with your provider; Ayushman Bharat often subsidizes.
Signs of complications?
Fever, severe leg pain, cold/pale limb, or wound redness.
How long does the graft last?
Aortobifemoral: 85–90% patency at 5 years; lifelong if no complications; axillobifemoral slightly lower (70–80%).
Lifestyle changes post-surgery?
Quit smoking, follow low-fat diet, exercise (30 min/day walking), take aspirin/statins, and attend follow-ups.
Conclusion
Aortoiliac bypass is a highly effective procedure for treating severe aortoiliac occlusive disease, with excellent outcomes for symptom relief and limb salvage. India’s top hospitals (Apollo, Fortis, AIIMS) provide affordable care, often covered by insurance. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach surgery confidently. Consult a vascular surgeon for personalized guidance.
Looking for Best Hospitals for Aortoiliac Bypass
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
2,00,000 |
4,50,000 |
Ahmedabad |
2,25,000 |
5,00,000 |
Ajmer |
2,00,000 |
4,50,000 |
Aligarh |
2,00,000 |
4,50,000 |
Allahabad |
2,00,000 |
4,50,000 |
Amritsar |
2,10,000 |
4,75,000 |
Aurangabad |
2,10,000 |
4,75,000 |
Bangalore |
2,25,000 |
5,00,000 |
Bareilly |
2,00,000 |
4,50,000 |
Belgaum |
2,10,000 |
4,75,000 |
Bhopal |
2,10,000 |
4,75,000 |
Bhubaneswar |
2,10,000 |
4,75,000 |
Bikaner |
2,00,000 |
4,50,000 |
Chandigarh |
2,25,000 |
5,00,000 |
Chennai |
2,25,000 |
5,00,000 |
Coimbatore |
2,25,000 |
5,00,000 |
Dehradun |
2,10,000 |
4,75,000 |
Delhi |
2,25,000 |
5,00,000 |
Dhanbad |
2,00,000 |
4,50,000 |
Durgapur |
2,00,000 |
4,50,000 |
Faridabad |
2,25,000 |
5,00,000 |
Ghaziabad |
2,25,000 |
5,00,000 |
Gorakhpur |
2,00,000 |
4,50,000 |
Guntur |
2,10,000 |
4,75,000 |
Gurgaon |
l2,25,000 |
5,00,000 |
Guwahati |
2,10,000 |
4,75,000 |
Gwalior |
2,00,000 |
4,50,000 |
Hyderabad |
2,25,000 |
5,00,000 |
Indore |
2,10,000 |
4,75,000 |
Jabalpur |
2,00,000 |
4,50,000 |
Jaipur |
2,25,000 |
5,00,000 |
Jalandhar |
2,10,000 |
4,75,000 |
Jamshedpur |
2,10,000 |
4,75,000 |
Jodhpur |
2,00,000 |
4,50,000 |
Kanpur |
2,00,000 |
4,50,000 |
Kochi |
2,25,000 |
5,00,000 |
Kolkata |
2,25,000 |
5,00,000 |
Kollam |
2,10,000 |
4,75,000 |
Lucknow |
2,10,000 |
4,75,000 |
Ludhiana |
2,25,000 |
5,00,000 |
Madurai |
2,10,000 |
4,75,000 |
Mangalore |
2,10,000 |
4,75,000 |
Meerut |
2,00,000 |
4,50,000 |
Moradabad |
2,00,000 |
4,50,000 |
Mumbai |
2,25,000 |
5,00,000 |
Mysore |
2,25,000 |
5,00,000 |
Nagpur |
2,10,000 |
4,75,000 |
Nashik |
2,10,000 |
4,75,000 |
Navi Mumbai |
2,25,000 |
5,00,000 |
Noida |
2,25,000 |
5,00,000 |
Patna |
2,00,000 |
4,50,000 |
Pune |
2,25,000 |
5,00,000 |
Raipur |
2,10,000 |
4,75,000 |
Rajkot |
2,10,000 |
4,75,000 |
Ranchi |
2,00,000 |
4,50,000 |
Surat |
2,25,000 |
5,00,000 |
Thane |
2,25,000 |
5,00,000 |
Vadodara |
2,10,000 |
4,75,000 |
Varanasi |
2,00,000 |
4,50,000 |
Visakhapatnam |
2,10,000 |
4,75,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.