Vascular Surgery

Inpatient arterial surgery – Cambridge University Hospital

Selected interventional radiology as a day case or overnight stay at Peterborough City Hospital.

Day case venous surgery Peterborough City Hospital

Outpatient clinic at Peterborough City Hospital (Arterial and Veins) and Stamford (Veins only)

Nurse led clinics for aneurysmal disease, complex wound care and intermittent claudication.

Nurse led urgent access clinic for critical limb threatening ischaemia

Multi-disciplinary Diabetic Foot clinic Peterborough City Hospital and Hinchingbrooke

Varicose veins can cause pain, swelling and skin problems and is the major cause of leg ulceration. Patients with chronic venous disease are assessed using ultra sound scanning, and have access to a range of treatments including radio frequency ablation, foam sclerotherapy, and vein stripping operations.

Blockages and narrowing of arteries to the legs can cause pain on walking and more severe problems such as constant pain in the foot and even tissue loss/gangrene.  In appropriate cases arteries can be stretched or unblocked using a balloon (angioplasty) or stent.  Where symptoms are severe or critical, surgery can be performed to remove or bypass the blockage.  Unfortunately where revascularisation is not an option, amputation may need to be considered.

An aneurysm is the enlargement of an artery caused by weakness in the arterial wall. Often there are no symptoms, but a ruptured aneurysm can lead to fatal complications. An aneurysm refers to a weakening of an artery wall that creates a bulge, or distention, of the artery. Aneurysms occur most often in the aorta, the main artery of the chest and abdomen but can occur in other arteries such as the popliteal (artery at the back of the knee) or splenic artery (the arterial supply to the spleen). Treatment options offered within the Cambridge Vascular Unit for aneurysm include stent graft repair (EVAR) and open surgery.  Aneurysms identified in the ascending aorta should be referred to the cardiovascular team.

A narrowing of the artery in the neck is the cause of some cases of stroke/TIA (transient ischaemic attack).  Carotid surgery is offered to improve the blood flow in symptomatic patients to reduce the risk of further strokes.

Leg ulceration occurs because of issues with circulation.  There are many known evidence based therapies available to treat the underlying causes of the leg ulceration, and many of these should heal within a matter of weeks.  It is important that any patient with chronic non healing ulceration has access to the appropriate intervention, and is referred in to the vascular service for further investigation.

Patients with diabetes can develop areas of ulceration on their feet, which can be complicated by infection, neuropathy (nerve damage) or ischaemia (peripheral arterial disease). Within NWAFT we have a highly specialised multidisciplinary team aiming to prevent and heal diabetic foot ulcerations as soon as possible. The team includes specialist podiatrist, diabetologist, orthopaedic surgeons and specialist nurses. Vascular specialists are able to provide local review and intervention within NWAFT if there is evidence of infection or ischaemia, it may be necessary for more complex treatment to be carried out at our arterial centre in Cambridge.

An excellent information resource can be found on the Circulation Foundation website:

https://www.circulationfoundation.org.uk

Vascular Disease is as common as cancer and heart disease. It accounts for 40% of deaths in the UK, many of which are preventable. Vascular disease is caused by inflammation and weakness of the veins and arteries.

The most common disease, peripheral arterial disease, affects the arteries in your legs; 9% of the population suffer from this form of vascular disease.

There are many factors that result in the increased risk of developing vascular disease:

Being male

Family history

High blood pressure

Smoking

Diabetes

Overweight

High cholesterol

Unhealthy diet

Lack of exercise