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)


  • 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.



Suite 27, Level 1 Wexford Medical Centre

3 Barry Marshall Pde

Murdoch WA 6150


(08) 9310 2322