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Q: Reduced blood flow in the legs and feet
asked by: DoctorQuestion on June 20th, 2009
3 weeks after an aorto-bifemoral bypass I am still experiencing ice cold feet (alternating left and right foot) and constant sharp needle like pains in feet adn thighs. What steps should I be taking. The surgeon has advised it could be nerve damage and I should see him again in 5 weeks, but has not prescribed any tests or drugs.


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Dr. Goce Aleksovski , MD
replied on June 24th, 2009
General Q and A Answer A6850


Aorto-bifemoral bypass is used to bypass blocked arteries in the abdomen. The arteries are blocked due to advanced atherosclerosis which narrows the arteries to the point where significant reduction of the blood flow appears. This leads to decreased blood flow in the legs, which is most easily noticed as cold legs and feet.

If the blood flow is reduced for a longer period, the structures (muscles and nerves) might be affected. The muscles might more or less atrophy, where as the nerves might sustain a certain amount of damage presented as tingling up to reduced sensory experience and pain.


According to the symptoms you provided (ice cold feet and needle like pain in feet), the symptoms might be related to the pre-existing condition. Please note that the neural tissue which builds the nerves does not regenerate.


Therefore, the surgery might increase the reduced blood flow, but there is a possibility that it might not be able to solve the neural damage problem.
You might want to visit a neurologist for a neural physical examination. A neural velocity signal test might be needed to determine the exact condition of the nerves.


Ceasing smoking would be highly recommended, because the smoke greatly contributes to the atherosclerosis which is the primary cause for this condition.




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