General Guidelines
Priority will be given to patients with critical limb ischaemia (rest pain, arterial ulcers, necrosis), symptomatic carotid stenosis and aortic aneurysm – who are likely to require surgical or radiological intervention.
Aortic Aneurysm
Patients with suspected aortic aneurysm, even without related symptoms, should be referred as an urgent case to the Vascular OP Clinic.
Patients with suspected symptomatic abdominal aortic aneurysm (i.e. recent onset or increasing back pain, acute tenderness of the aneurysm, distal embolism) should be referred as an emergency to the Receiving Surgical Team.
Varicose Veins
NHS Lanarkshire does not offer treatment for thread veins or reticular veins or any cosmetic treatment for varicose veins.
Referral Criteria For Varicose Veins
(MANDATORY FIELDS AT LEAST ONE REQUIRED)
- Open or healed varicose ulcer
- Active varicose eczema (unresponsive to topical steroids and compression)
- Recurrent superficial thrombophlebitis requiring NSAID therapy and compression
- (* Phlebitis/thrombophlebitis is defined as acute onset, tender, hard, lumpy veins due to thrombosis. It is Not just painful veins. Standard treatment is NSAIDs and compression, not antibiotics. Patients should not be referred on first episode unless there is clinical evidence of thrombosis extending up to the groin)
- A history of venous haemorrhage where there is a likelihood of further bleeding
Leg Ischaemia
Most patients with recent onset intermittent claudication will improve spontaneously – especially if they are encouraged to correct known risk factors. Furthermore timely attention to secondary prevention will reduce mortality and morbidity due to cardiac and cerebro-vascular disease in this high-risk group. Patients with mild to moderate intermittent claudication do not require invasive vascular interventions. If you have access to ABPI measurements, then that may help confirm the diagnosis.
Patients with severe intermittent claudication, not improved by a regime of smoking cessation, walking exercise, antiplatelet treatment, statin, weight reduction (as required) should be referred for vascular OP Clinic assessment.
Patients with suspected aortic aneurysm, even without related symptoms, should be referred as an urgent case to the Vascular OP Clinic.
Patients with suspected symptomatic abdominal aortic aneurysm (i.e. recent onset or increasing back pain, acute tenderness of the aneurysm, distal embolism) should be referred as an emergency to the Receiving Surgical Team.
Carotid Artery Disease
Patients with suspected carotid artery disease should be referred urgently if they present with symptoms of stroke, TIA, or amaurosis fugax.