Surgical Bypass for Aortoiliac Occlusive Disease 

Severe blockages in the aorta or iliac arteries in your pelvis may require a surgical bypass. 

Blockages in the aorta or iliac arteries in your pelvis can cause severe discomfort in your legs when you walk. Sometimes the blockages may be so severe that your feet hurt even when lying down (rest pain), or wounds develop on your legs because of lack of blood flow. A surgical bypass reroutes blood flow around the blocked artery to increase blood flow to your legs and improve symptoms. 

Conditions Treated 

Aortoiliac occlusive disease is a type of vein condition in the aorta (the main blood vessel in the body) or the iliac arteries in the legs. The aorta branches into the iliac arteries around the level of the belly button to provide blood to the legs and the organs in the pelvis. When a blockage occurs and presents severe symptoms, a surgical bypass may become necessary to treat it.  

Procedure Details 

There are two different types of surgical bypasses for aortoiliac occlusive disease: 

  • Aortofemoral bypass – This involves making an incision down the middle of the abdomen to access the aorta and place a graft, connecting it to one or both of the femoral arteries (which extend from the iliac artery into the leg) to bypass a blocked or diseased vessel. The graft is sewn into place above the blockage on the aorta and below the blockage on the femoral artery/arteries. 
  • Axillofemoral or axillobifemoral bypass – The axillary artery, which routes blood from your neck to your arm, is used as the source of blood flow instead of the aorta. 

What to Expect 

As with most types of surgery, a bypass for aortoiliac occlusive disease can have possible complications. These include: 

  • Death 
  • Heart attack 
  • Stroke 
  • Wound problems 
  • Graft infections 
  • Graft blockage 
  • Limb loss 


Overall, bypass surgery is immediately successful in 90% to 95% percent of cases. The success of the procedure is most closely linked to the material employed for the bypass graft itself, the quality of the arteries in the lower leg to which the graft is attached and the expertise of the surgeons performing the procedure. You can feel confident knowing that Tampa General Hospital’s vascular surgeons are among the best in the country.