|Carotid disease is where plaque accumulates within one of the main arteries that supply blood to the brain. In some individuals this plaque can accumulate to the stage where signifcant narrowing can develops. This is usually managed with medication and lifestyle modification within the first instance. Plaque can be prone to breaking up and going to the brain causing stroke or ministroke. In some individuals a carotid endarterectomy is recommended. This is where the plaque is removed surgically to reduce the likelihood of further or recurrent stroke.|
Peripheral Vascular Disease (PVD) & Diabetic Ulcers
Peripheral vascular disease is where narrowings develop in the arteries that supply the lower limbs (and very rarely the upper limbs).
In patients with chronic diabetes, or advancing age this can cause to chronic wounds, ulcers and gangrene. The goal of surgery is to restore perfusion to the limb involved to prevent further deterioration of the ulceration and ultimately prevent limb loss. Surgery involved can include minimally invasive key hole surgery (angiogram and angioplasty/stenting) and in some instances more advanced open reconstructive surgery.
Surgery for dialysis access
|When patients are commenced on dialysis, we aim to create autogenous dialysis access whenever possible. This involves using a patients native artery and veins to create a fistula. This has many advantages, but none of which as important as creating reliable and durable dialysis access that avoids the need for any synthetic and prosthetic material.|
Aortic Aneurysm (AAA)
|An aortic aneurysm is a bulge or weakening that forms within one of the major arteries of the body – the aorta. The weakness of the wall generally increases as the size of the aneurysm increases. In some cases surgery is recommended to fix the aneurysm to prevent major bleeding occuring which is often fatal. Surgical options include minimally invasive repair (stent graft repair) or traditional open surgery. Not every one is suitable for both options and treatment needs to be invididualised for each patient.|
Similar to an aortic aneurysm, a visceral aneurysm is also bulge or weakening that has developed in one of the arteries to one of the major organs of the body such as the spleen or kidneys.
When these aneurysms reach a certain size, again surgery may be recommended to prevent any of these aneurysms from rupturing or bleeding. The type of surgery various significantly depending on the location of the lesion, whether or not the patient is pregnant and their pre-existing health and functional capacity. Usually treatment is recommend as per the current American Society of Vascular Surgery Guidelines (SVS) (SVS Visceral Aneurysms)
Thoracic aortic aneurysm (TAAA) and Dissection
|Disorders of the thoracic aorta range of dissection (tearing in one of the layers), intramural haematoma (bruising in the wall – usually associated with plaque), to aneurysms (bulging and weakening). Treatment is sometimes recommended to avoid specific complications from these disorders. The can include bleeding or rupturing to paraplegia (loss of motor and sensory dysfunction to the lower limbs) to impaired blood flow to the kidneys, gut or legs. Generally modern treatment involves relining the inside of the thoracic aorta with a stent graft. Generally, treatment for these procedures are carried out in major public hospitals.|
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“Alone we can do so little, together we can do so much.” — Helen Keller
© Sam Farah 2021