Vascular Surgery

The Vascular Surgery service diagnoses and manages vascular diseases.

We provide a surgical service for people who have problems relating to their blood vessels, including:

• a full range of venous (vein) and arterial (artery) surgery
• assisting in renal (kidney) transplant and providing access for haemodialysis (dialysis)
• diagnostic angiography (a special x-ray to look at the arteries)
• endovascular (inside the blood vessels) procedures
• treatment for blockages following bypass graft surgery

Outpatient Department, Level 3F.3, Royal Adelaide Hospital.

The Vascular Surgery service for Central and Northern Adelaide is based at the Royal Adelaide Hospital (RAH), but consults and operates at several sites across the networks based on disease complexity and patient needs. We aim to provide care as close to the patients home as possible.

• Dr David King – Head of Unit Royal Adelaide Hospital (RAH) Vascular Unit
• Dr Ewan Macaulay – RAH, Llyell McEwin Hospital (LMH) (sclerotherapy only) 
• Dr Michael Herbert – RAH, The Queen Elizabeth Hospital (TQEH), LMH, Murray Bridge and Whyalla
• Dr Kurian Mylankal – RAH, Modbury, LMH and Wallaroo
• Dr Joseph Dawson – RAH, TQEH and Port Lincoln
• Dr Conor Marron – RAH, LMH and Gawler
• Professor Fitridge – TQEH
• Dr Peter Subramaniam – TQEH 
• Dr Sharon Hong – RAH and TQEH

You need a referral letter from your GP or medical practitioner to access this service.

Your doctor will need to fax your referral letter to us. We will be in contact with you within clinically recommended times, depending on waiting list length. If there is no waiting list, you will receive an appointment booking letter or we will contact you to arrange a suitable time.

Vascular Surgery services require a written referral from a GP or specialist before patients can access this service.

All referrals are triaged by the service according to clinical urgency. Patients who are unstable and require immediate assessment should be sent directly to the nearest Emergency Department. 

To refer your patient, follow the outpatient service information, triage and referral guidelines, complete and fax a referral to us. For urgent referrals, also contact the registrar on call to discuss the case. Our registrars are on call 24 hours a day 7 days a week on the enquiries telephone number below.

• Vascular outpatient service information triage and referral guidelines (PDF 243KB)
   

To ensure appropriate and timely triage, include all demographic and clinical details as well as relevant investigation results.  
 

Referral — Fax: (08) 7074 6247
Enquiries — Phone: 1300 153 853 

If you are concerned about any delay of the appointment or if there is any deterioration in your patient’s condition, telephone the Registrar/Fellow on-call via the RAH switchboard: (08) 7074 0000

• Dr David King - Head of Unit Royal Adelaide Hospital (RAH) Vascular Unit
• Dr Ewan Macaulay - RAH, Llyell McEwin Hospital (LMH) (sclerotherapy only) 
• Dr Michael Herbert - RAH, The Queen Elizabeth Hospital (TQEH), LMH, Murray Bridge and Whyalla
• Dr Kurian Mylankal - RAH, Modbury, LMH and Wallaroo
• Dr Joseph Dawson - RAH, TQEH and Port Lincoln
• Dr Conor Marron – RAH, LMH and Gawler
• Professor Fitridge - TQEH
• Dr Peter Subramaniam - TQEH 
• Dr Sharon Hong — RAH and TQEH

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Foot clinics

Multidisciplinary Foot Clinics are held at RAH, LMH & TQEH to assess people with complex diabetic foot issues with combinations of biomechanical, neuropathic, ulceration, infection and ischemia. 

Referrals can be faxed to the Allied Health departments RAH/TQEH Fax (08) 7074 6247 or LHN Fax (08) 8182 9440

For all enquires please contact the podiatry department of the relevant hospital; out of hours calls can be directed to Vascular on-call via RAH switchboard (08) 7074 0000

Claudication

• Please note that all claudicants should be advised to stop smoking, and commenced on both a statin and antiplatelet agent before referring for review.
• We also provide Claudicant Rehab program to assist in improving symptom management at the RAH. Transport for this clinic is at the patient’s own expense.  If you patient is interested in this please state this in your referral.

Varicose veins

• A Venous duplex scan identified in subsection clinical categories/process should also be provided at the point of referral.
• Inappropriate referrals will be declined for treatment in public health and will not receive an appointment.
• Compression hosiery is not provided by the RAH.
• Compression can be sourced after an ABI or toe pressure has been completed.
• Patient are expected to purchase and supply their own garments for ongoing management of venous disease and lymphoedema.

Lymphoedema

• Lymphoedema management without ulceration is best managed by the physiotherapy Departments at TQEH & LMH.
• Compression hosiery is not provided by the RAH.
• Compression can be sourced after an ABI or toe pressure has been completed.
• Patient are expected to purchase and supply their own garments for ongoing management of venous disease and lymphoedema.
• Please direct any lymphoedema referrals directly to the Allied Health Department (TQEH) Fax (08) 8222 6621 or (LMH) Fax (08) 8182 9440.

The following information sheets about presentations commonly seen in vascular outpatients provide the minimum information required for assessing a referral under the headings of: eligibility, priority, differential diagnosis, clinical information and investigations required, pre-referral management strategies and discharge criteria.

• Abdominal aortic aneurysm (PDF 127KB)
• Symptomatic carotid artery disease (PDF 128KB)
• Diabetic foot infection (PDF 126KB)

The CALHN Vascular Surgery service provides a centralised remote surveillance program.

This program provides a service for patients who do not have a clinical need to attend the outpatient department for review but do require ongoing imaging for either established vascular disease or following vascular intervention.

The program is managed by a full time vascular nurse under the supervision of consultant vascular surgeons.

Clinically stable patients are offered enrolment into the program by their treating consultant and can elect to be monitored by remote review of surveillance imaging (usually Duplex ultrasound) in lieu of routine outpatient clinic appointments after the scan is performed.

• The clinician may recommend an imaging provider at the time of enrolment. This may be the closest provider to the patient’s home, or a provider who has specialty skills in vascular ultrasound imaging. The specialist vascular ultrasound providers (Vascular Ultrasound partners, Adelaide Vascular and SA Medical Imaging) bulk-bill all studies. Other private radiology providers may or may not bulk-bill the patient. Any financial interests of the surgeon e.g ownership of the scanning practice will be disclosed to the patient when selecting the scanning location.
• The general practitioner is advised of each patient’s enrolment into the program and is regularly updated with imaging reports.
• Clinical review in the vascular outpatient department is organised by the surveillance nurse if there are any concerns noted on routine imaging.

For General Practitioners and Primary Health Care Clinicians

If your patient is currently enrolled in the vascular remote surveillance program and you have any concerns regarding their surveillance please contact the Vascular Surveillance Clinical Nurse on either telephone: (08) 7074 2511 or email Health.RAHVascularRemoteSurveillance@sa.gov.au