Tag: aneurysm

Vascular General Referral

Scott McLaughlin

General Vascular Referral

Please Note: This referral must only be used for general vascular referrals where no other referral form is available.

There are specific referral forms available for the following:

  • Aortic Aneurysm
  • Leg Ischaemia
  • Carotid Artery
  • Varicose Veins

Where any of these presenting problems are suspected, the relevant referral form should be completed.

Leg Ischaemia

Most patients with recent onset intermittent claudication will improve spontaneously – especially if they are encouraged to correct known risk factors (e.g. smoking, cholesterol, hypertension, obesity, low activity level). 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.

Patients with suspected mild to moderate intermittent claudication may be referred to the local Community Claudication Clinic (via SCI Gateway) for confirmation of the diagnosis, cardiovascular risk factor assessment and appropriate counselling.

The Community Claudication Clinic

Our service has been set up in eight clinics across Lanarkshire for patients with suspected intermittent claudication (i.e. early peripheral arterial disease). We offer initial assessment and management by a Vascular Nurse and onward referral to the Vascular Physiotherapist and local services as appropriate.

NB We are unable to provide patient transport to the Community Claudication Clinic.

Fasting blood sugar, fasting lipids and full blood count, prior to referral, would facilitate patient management.

Patients with severe intermittent claudication, not improved by a regime of smoking cessation, walking exercise, antiplatelet treatment, statin, weight reduction etc. may be referred for Hospital Vascular OP Clinic assessment.

Patients with suspected critical limb ischaemia (rest pain, arterial ulcers, necrosis) should initially be discussed by contact with one of the Vascular Secretaries at Hairmyres Hospital in hours on Hairmyres 01355 584743. Appropriate arrangements will be confirmed by return call.

In the case of suspected ACUTE limb ischaemia with possible immediate limb threat (e.g. failed perfusion and sudden diminished sensation and movement): please refer as an emergency via ERC to the receiving surgical team.

Aortic Aneurysm

Patients with aortic aneurysm > 5cm, even without related symptoms, should be referred as an urgent case to the Hospital Vascular OP Clinic. Smaller aortic aneurysms may be referred as routine cases.

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 via ERC to the receiving surgical team

Carotid Artery Disease

Patients with suspected carotid artery disease should be referred urgently to the Stroke Service via SCI Gateway if they present with symptoms of stroke, TIA, or amaurosis fugax.

Leg Ischaemia Guidelines

Scott McLaughlin

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.

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.

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

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.

Carotid Artery Disease

Patients with suspected carotid artery disease should be referred urgently if they present with symptoms of stroke, TIA, or amaurosis fugax.

Community Claudication

Scott McLaughlin

General Guidelines

Priority will be given to patients with critical limb ischaemia (severe rest pain, arterial ulcers, necrosis), symptomatic carotid stenosis and aortic aneurysm – who are likely to require surgical or radiological intervention.

Leg Ischaemia

Most patients with recent onset intermittent claudication will improve spontaneously – especially if they are encouraged to correct known risk factors (e.g. smoking, cholesterol, hypertension, obesity, low activity level). 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.

Patients with suspected mild to moderate intermittent claudication may be referred to the local Community Claudication Clinic (via SCI Gateway) for confirmation of the diagnosis, cardiovascular risk factor assessment and appropriate counselling.

The Community Claudication Clinic

Our service has been set up in eight clinics across Lanarkshire for patients with suspected intermittent claudication (i.e. early peripheral arterial disease). We offer initial assessment and management by a Vascular Nurse and onward referral to the Vascular Physiotherapist and local services as appropriate.

NB We are unable to provide patient transport to the Community Claudication Clinic.

Fasting blood sugar, fasting lipids and full blood count, prior to referral, would facilitate patient management.

Patients with severe intermittent claudication, not improved by a regime of smoking cessation, walking exercise, antiplatelet treatment, statin, weight reduction etc. may be referred for Hospital Vascular OP Clinic assessment.

Patients with suspected critical limb ischaemia (rest pain, arterial ulcers, necrosis) should initially be discussed by contact with one of the Vascular Secretaries at Wishaw general Hospital or Hairmyres Hospital in hours on WGH 01698 366549 and HM 01355 584743. Appropriate arrangements will be confirmed by return call.

In the case of suspected ACUTE limb ischaemia with possible immediate limb threat (e.g. failed perfusion and sudden diminished sensation and movement): please refer as an emergency via ERC to the receiving surgical team.

Aortic Aneurysm

Patients with aortic aneurysm > 5cm, even without related symptoms, should be referred as an urgent case to the Hospital Vascular OP Clinic. Smaller aortic aneurysms may be referred as routine cases.

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 via ERC to the receiving surgical team.

Carotid Artery Disease

Patients with suspected carotid artery disease should be referred urgently to the Stroke Service via SCI Gateway if they present with symptoms of stroke, TIA, or amaurosis fugax.

Aortic Aneurysm

Scott McLaughlin

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.

Aortic Aneurysm Template