Leg circulation issues and bypass surgery: what to expect?

My mom is dealing with some really serious arterial circulation issues in her right leg. It actually landed her in the hospital last year. The doctors decided against doing a bypass surgery because she’s so prone to blood clots; they’re terrified a thrombus would just form on the graft itself. She’s had deep vein thrombosis in both legs several times, so she’s been on Warfarin continuously for years now. About a year ago, things were pretty scary—she was in constant pain, dealing with nighttime claudication even while resting, and her pinky toe turned completely blue, which looked like the start of dry gangrene.

After several months, things have improved somewhat. Her pinky toe is fine now, but she still gets those sharp pains whenever she walks. Thankfully, the pain at rest has stopped. Some collateral vessels have formed to help out a little bit, too. I guess I’m just incredibly worried😢 because I’ve read that this inevitably gets worse over time. Since she has kidney issues, high blood pressure, and a major tendency toward clotting, she isn't really considered a candidate for surgery. Specifically, her popliteal artery—the one running down from the knee—is blocked. She can't walk very far; after maybe 300 or 400 yards, her calf starts hurting so badly she has to sit down for a few minutes just to catch her breath. On top of all this, she went back to working full-time last year, even though she’s technically eligible for Social Security based on her age and years of service. Most of her job is sitting, but I suppose even that is more taxing than staying home.

I’ve spent a lot of time researching this online. Most of what I found in American sources was pretty general, so I had to dig through some specialized medical journals in English to get a real handle on things. She sees her vascular surgeon every three months for checkups, and she gets blood work done even more frequently to monitor her clotting levels. The last time she had an arterial Doppler and pressure index test was nine months ago, since her surgeon hasn't ordered a follow-up yet.

My question is, does anyone know someone here in the States who has undergone a leg bypass surgery? I'd love to hear how the procedure went and if their condition actually improved afterward. I get the feeling that maybe these cases aren't super common, so I'm wondering if this is considered a routine procedure at major hospitals like the Mayo Clinic or Johns Hopkins. I'm looking for real-life experiences. Also, what would you say are the premier medical centers in the world for vascular diseases and surgeries? Which cities or countries should we be looking toward?

Thanks so much in advance for any insight you can share.

Best regards,

Any vascular surgeon around here can handle a femoral-popliteal bypass procedure without breaking a sweat; it’s definitely not some ultra-rare, high-stakes surgery that only specialists touch.
That being said, let's be real—every single surgery carries its own set of risks, and those high blood pressure issues you mentioned certainly don't help things along.
But honestly, as long as there's solid prep work done beforehand and they get the post-op blood thinner regimen dialed in perfectly, the outcome should be fine.