Concierge vascular surgery · London
Private femoro-popliteal bypass surgery in London, by a consultant vascular surgeon.
Open vascular reconstruction for a leg with critical ischaemia or lifestyle-limiting claudication — by a named consultant vascular surgeon, in a hospital with HDU cover, and with endovascular alternatives properly considered first.
Why patients choose us
- 01
A consultant vascular surgeon, in a proper theatre
Not a training list and not a mixed generalist clinic. A named vascular surgeon, an anaesthetist you meet before the day, and a hospital set up for HDU care.
- 02
Endovascular alternatives on the table first
For short blockages, angioplasty and a stent may do the job. We say so — and refer for endovascular first — before you commit to open bypass.
- 03
Independent, and free
We are paid by no hospital, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private fem-pop bypass costs in London.
Indicative ranges across our partner hospitals. Send the details and we quote firm figures across two or three options.
In short
Above-knee vein bypass in our network: £18,000–£28,000, home in 4–7 days.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Above-knee fem-pop bypass (vein) | £18,000–£28,000 | 3–4 hrs | 4–7 days inpatient |
| Above-knee fem-pop bypass (PTFE / prosthetic) | £16,000–£24,000 | 3–4 hrs | 4–7 days inpatient |
| Below-knee fem-distal bypass (vein) | £22,000–£35,000 | 4–6 hrs | 5–10 days inpatient |
| Redo / revision bypass | £25,000–£40,000 | 5–7 hrs | 5–10 days inpatient |
| Endovascular first look (angioplasty ± stent) | £6,000–£12,000 | 60–90 min | Day-case / 1 night |
| Vascular consultation only | £250–£450 | 30–45 min | Same visit |
Prices vary by hospital, by the vascular surgeon, by the anaesthetic chosen, and by the complexity of the disease (above-knee vs below-knee, vein vs prosthetic, primary vs redo). We come back with a firm quote within one working day.
The problem
The right surgeon, the right operation, the right hospital.
Fem-pop bypass is major surgery on patients who are usually elderly and often cardiac-frail. Getting the decision right — bypass or stent, vein or prosthetic, above or below the knee — matters more than the surgery itself.
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Not sure it is needed?
For short blockages, angioplasty and a stent may do the job. NICE NG147 says lifestyle-limiting claudication needs a 3-month proper trial of medical therapy first.
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Worried about the risk?
Cardiac work-up, HDU cover and an experienced vascular anaesthetist are the difference between a routine bypass and a serious event.
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Want it done properly?
A named consultant vascular surgeon, MDT decision-making with interventional radiology, and 24-hour vascular cover at the hospital.
The journey
From enquiry to recovery — what happens, in order.
One vascular surgeon from first message to surveillance duplex — including the recovery window and the lifelong medications.
Phase 1 · Before your operation
Concierge, off-stage for you
Phase 2 · Admission and surgery
4–7 days in hospital
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Symptoms — walking distance, rest pain, an ulcer that will not heal — plus your scans and medications so far.
- 02
Before
We come back with a recommendation
Within one working day: whether an endovascular first look is right, or whether open bypass is the honest answer for the pattern of disease. If it can be managed without surgery, we say so.
- 03
Before
Work-up and vein mapping
Duplex ultrasound, CTA or MRA, cardiac assessment, and bilateral great saphenous vein mapping — the vein is the graft, and we need to know its calibre before the day.
- 04
On the day
Admission and anaesthetic
Admission the morning of surgery (or the night before), consent, and the anaesthetist. General or regional (spinal / epidural) — chosen with you.
- 05
On the day
The operation itself
Three to six hours in theatre. Groin and distal incisions, vein harvest or prosthetic graft prepared, tunnel created, anastomoses fashioned, and flow confirmed on-table.
- 06
On the day
HDU overnight
24–48 hours in HDU or step-down for close observation of the graft, pain control and cardiac monitoring.
- 07
After
Ward, mobilisation and home
Four to seven days total in hospital, mobilising day one to two, drains out at 24–48 hours, DVT prophylaxis, and a written surveillance plan before discharge.
Typical end-to-end: 2–4 weeks from enquiry to surgery. Return to office work: 4–6 weeks.
When it helps
When femoro-popliteal bypass is the right step.
The patterns of disease that lead to bypass, plus the one red flag that means an emergency rather than an appointment.
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Chronic limb-threatening ischaemia (CLTI)
Rest pain in the foot, non-healing ulcer or gangrene — urgent revascularisation, and often bypass when the disease is long-segment.
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Lifestyle-limiting claudication
Calf or thigh pain on walking that stops you doing what you need to — after 3 months of proper medical therapy and supervised exercise.
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Long-segment SFA disease (TASC C/D)
Long or complex superficial femoral artery blockages where angioplasty and stenting are unlikely to give durable results.
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Failed endovascular treatment
Stents that have occluded, or angioplasty that has not held — bypass is often the honest next step.
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Tibial-vessel disease with CLTI
Below-knee disease threatening the foot — fem-distal bypass to a tibial or peroneal vessel to save the limb.
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Good autologous vein available
A great saphenous vein of at least 3 mm calibre — the gold-standard graft, with the best long-term patency.
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Diabetic foot with pattern of disease
A diabetic ulcer that will not heal with a pattern of infrainguinal disease — MDT decision on bypass versus endovascular.
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Red flag: acute limb ischaemia
A cold, pale, painful, pulseless leg with sensory or motor loss is an emergency — 999 or A&E the same hour, not a clinic booking.
Procedure options
Open bypass is not the only option.
What each option on the table actually involves — and which fits which pattern of disease.
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Above-knee fem-pop bypass (vein)
Groin to above-knee popliteal, using reversed or in-situ great saphenous vein. Best long-term patency — about 70% at five years.
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Above-knee fem-pop bypass (PTFE / Dacron)
Prosthetic graft when no suitable vein is available. Patency lower than vein — around 50% at five years — but a valid option above the knee.
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Below-knee fem-distal bypass
Groin to below-knee popliteal or tibial vessels — used for CLTI when the disease extends past the knee. Vein is strongly preferred here.
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In-situ vein bypass (with valvulotomy)
The great saphenous vein is left in place, valves are cut with a Mills valvulotome, and side branches are ligated. Preserves vein calibre matching.
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PTFE-vein composite (Miller cuff / Taylor patch)
A cuff or patch of vein at the distal anastomosis of a prosthetic graft — improves patency of infragenicular PTFE bypasses.
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Endovascular first (angioplasty ± stent)
For short TASC A/B lesions, or where a patient is high-risk for open surgery. Faster recovery, but not always durable in long-segment disease.
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Redo / revision bypass
A previous bypass that has occluded, or a stenosis picked up on surveillance duplex — targeted angioplasty or a new bypass, decided by MDT.
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Vascular consultation only
An honest discussion of whether surgery is needed at all, whether endovascular is a better first step, and what the timeline looks like.
Our vetted London network
A small panel of vascular surgeons, we picked them.
Consultant vascular surgeons across central and south London, all operating at hospitals with HDU cover and interventional radiology on-site. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every vascular surgeon in our network.
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Consultant vascular surgeons, not trainees or general clinicians
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MDT decision-making (vascular surgeon, interventional radiologist, anaesthetist) before booking
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Endovascular alternatives considered and offered where appropriate
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HDU and 24-hour vascular cover at the operating hospital
Safety and recovery
What to expect afterwards — honestly.
Fem-pop bypass is major open surgery. The things that decide how well you do are the anaesthetic pathway, the wound, the graft surveillance and lifelong cardiovascular protection.
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General or regional anaesthetic
GA or spinal / epidural — chosen with the anaesthetist. Fem-pop bypass is major surgery and cardiac work-up is part of the pathway.
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HDU for 24–48 hours
Close observation of the graft, blood pressure, pain and cardiac status. Standard for any open bypass — not a sign that something has gone wrong.
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Wound problems are the commonest issue
Groin and calf wounds heal slowly in about 10–20% — higher if you are diabetic, obese or a smoker. Most settle with dressings and antibiotics.
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Graft infection is rare but serious
Under 5%, but when it happens it can mean removing the graft and rerouting — a reason we insist on a proper theatre and prophylactic antibiotics.
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Cardiac risk is the biggest long-term risk
People with peripheral arterial disease have MI and stroke risk similar to established coronary disease. Statin, antiplatelet and BP control are lifelong.
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DVT prophylaxis and early mobilisation
Low-molecular-weight heparin and up out of bed on day one to two. Reduces DVT, pneumonia and stiffness.
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Saphenous nerve numbness
A patch of numbness on the medial calf after in-situ vein bypass is common, usually settles, and does not affect walking.
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Surveillance duplex saves grafts
Duplex at six weeks, three, six, twelve months and then annually — picks up graft stenosis before it occludes, so a small angioplasty can save the bypass.
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Red flags
A suddenly cold, pale, painful leg after bypass; heavy bleeding, spreading redness or fever are not normal — call the vascular team or A&E the same hour.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used, the note the vascular surgeon sends you keeps to the same shape.
A quiet reminder
Vascular language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your follow-up, just ask.
- 01 Header
Indication and inflow / outflow chosen
Why the operation was done — CLTI, disabling claudication — and which arteries were used (common femoral to above-knee popliteal, or to a below-knee target).
- 02 Technique
Conduit, tunnel and anaesthetic
Whether great saphenous vein (reversed or in-situ) or PTFE / Dacron was used, the tunnel route (subsartorial or subcutaneous), and the anaesthetic type.
- 03 Findings
On-table flow, run-off and complications
Completion angiogram or duplex findings, quality of the target vessel and run-off, and any intra-operative issues.
- 04 Impression
Medications, surveillance and warning signs
Read this first: antiplatelet or DOAC, statin, wound care, the surveillance duplex timetable, and the symptoms that mean calling the vascular team.
Recognised by major UK insurers
Cover for fem-pop bypass is usually available when medically indicated for CLTI or disabling claudication that has failed medical therapy. We confirm cover and any excess before booking.
Frequently asked
Everything we get asked about fem-pop bypass.
Quick answers on vein vs prosthetic, risks, recovery, cost and surveillance.
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Why would I need a femoro-popliteal bypass rather than a stent?
For short blockages (TASC A/B), angioplasty and stenting are usually first-line and less invasive. For long-segment disease (TASC C/D), or where stents have failed, open bypass gives more durable results — especially with your own vein. The BEST-CLI and BASIL-2 trials support vein bypass first for CLTI when a good vein is available.
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Vein or prosthetic graft — which is better?
Your own great saphenous vein is the gold standard. Five-year primary patency is around 70% with vein and around 50% with PTFE or Dacron. Prosthetic grafts are used when the vein is too small, too diseased or already used. Below the knee, vein is strongly preferred.
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How long is the hospital stay?
Typically four to seven days for an above-knee bypass and five to ten days for a below-knee or fem-distal bypass. You will spend 24–48 hours in HDU or a step-down bed, then move to a ward as you mobilise.
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How much does a private fem-pop bypass cost in London?
Roughly £18,000–£28,000 for an above-knee vein bypass, £16,000–£24,000 for a prosthetic above-knee bypass, and £22,000–£35,000 for a below-knee or fem-distal bypass. Redo surgery is more. We confirm a firm figure within one working day.
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What are the main risks?
Wound infection or breakdown (10–20%), graft infection (under 5%), MI (3–5%), DVT, saphenous nerve numbness after in-situ vein bypass, pseudoaneurysm, graft occlusion (early or late), and — despite bypass — amputation in 5–15% at five years. Peri-operative mortality is 2–3%, higher in emergency or frail patients.
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What is the recovery timeline?
HDU overnight, ward for four to seven days, mobilising from day one to two. Drains out at 24–48 hours. Office work at four to six weeks. No heavy lifting for six weeks. Wound checks and a first surveillance duplex at six weeks.
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Do I need to stop my blood-thinning medication?
Some medications need adjusting before surgery and some do not. Aspirin is usually continued. Warfarin, DOACs or clopidogrel are reviewed by the vascular team on a case-by-case basis. Never stop them without advice.
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What lifestyle changes matter most?
Stopping smoking is the single most important thing you can do — for graft patency, wound healing and long-term survival. A statin, antiplatelet, blood pressure control and foot care are lifelong. Supervised exercise helps even after surgery.
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Will I need surveillance after the operation?
Yes. Duplex ultrasound at six weeks, three, six and twelve months, then annually. This picks up graft stenosis before it causes occlusion — a small angioplasty on a narrowed graft is far better than treating a fully blocked one.
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When should I go to A&E rather than call the clinic?
A suddenly cold, pale, painful or numb leg is acute limb ischaemia and needs 999 or A&E the same hour. Heavy bleeding, spreading redness, fever or a wound that suddenly opens also needs same-day medical help.
Related treatments
Looking for something else?
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Femoral endarterectomy
Opening and clearing the common femoral artery — often at the inflow of a bypass.
Learn more -
Carotid endarterectomy
Clearing plaque from the carotid artery to reduce stroke risk.
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Endovascular aortic aneurysm repair (EVAR)
Keyhole repair of an abdominal aortic aneurysm.
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All tests & procedures
Every test and procedure we arrange.
Learn more
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