Referrals
Below is a summary of which patients you should be referring to a vascular surgeon –
Varicose Veins:
- Patient request ie cosmetic,discomfort,pain, concerns regarding clotting etc
- Oedema in the affected leg
- Thrombophlebitis
- Signs of chronic venous hypertension ie venous pigmentation,lipodermatosclerosis, venous ulcers
- Pre-referral investigations: Duplex for venous incompetence (not necessary if patient just wants sclerotherapy for spider veins)
Peripheral arterial disease
- Any patient with symptoms of claudication
- Development of rest pain (Urgent)
- Non-healing or painful ulcers (Urgent)
- Gangrene (needs admission within 24hours: preferably call vascular surgeon)
- Diabetic patient with infected foot ulcer or pus in the foot: This is an emergency requiring immediate hospital admission for intravenous antibiotics +/- urgent surgical debridement (PLEASE CALL VASCULAR SURGEON FOR DIRECT ADMISSION OR SEND PATIENT TO EMERGENCY DEPARTMENT)
- Pre-referral investigations: Arterial Duplex only (No need for CT or MRI) if time allows
Abdominal Aortic Aneurysms (AAA)
- Monitor with annual Ultrasound if AAA < 4.0cm
- Refer to vascular Surgeon when AAA >4.0cm
- Pre-referral investigations : AAA duplex (No need for CT or MRI)
Carotid Artery disease
- Symptomatic patient (TIA or Stroke) with >50% carotid stenosis
- Asymptomatic patient with >70% stenosis
- Pre-referral investigations : carotid artery duplex (No need for CT or MRI)
Other
- Mesenteric or Renal artery aneurysms of any size
- Arm or hand ischaemic symptoms including severe Raynaud’s syndrome
- Arteriovenous malformations which are symptomatic to the patient
To refer your patients to Dr Shakibaie for vascular and endovascular consultation or surgery, please send a referral letter.
Post
Suite 27, Level 1 Wexford Medical Centre
3 Barry Marshall Pde
Murdoch WA 6150
Fax
(08) 9310 2322