Mater Specialist Quick Find

Vascular Surgery – public patients

Purpose

This page contains information on how to refer patients aged 16 years and over to Vascular Surgery specialist outpatient services at Mater Hospital Brisbane.

Service 

The Vascular service is an integral member of the Multidisciplinary High Risk Foot Service, which comprises of medical specialists (from Diabetes and Endocrine, Orthopaedics and Vascular), wound nurses, podiatrists and clinical nurses who collaboarate at a fortnightly clinic to develop individualised plans of care. 

The Vascular service consistently reviews and treats our patients within the recommended OPD categorisation time frames. 

How to Refer

If referral for care is indicated please list all of the General Referral Information and reason for request, and essential information as indicated below.

To refer, please fill in the Mater Adult Referral Form, available to download and embed into most major Practice Management software applications.

Referrals can be sent by:

Secure messaging  Medical Objects:   HM4101000R8
  HealthLink EDI:    materref   
Fax    07 3163 8548

 

 

 

 

Emergency

If any of the following are present or suspected, phone 000 to arrange immediate transfer to the emergency department or seek emergency medical advice if in a remote region:

 

View list of conditions:

  • Crescendo or multiple recent TIA (Transient Ischemic Attack) / amaurosis fugax
  • Acute aortic dissection
  • Ruptured AAA
  • Symptomatic AAA (abdominal/back pain/tenderness, compressive symptoms, distal embolisation)
  • Axillary vein thrombosis, iliofemoral DVT
  • Active infection in leg with peripheral arterial disease
  • Diabetic foot infection (refer to high-risk foot pathway)
  • Acute arterial ischemia/threatened limb
  • Thrombosed AVF (refer to vascular registrar on call or the renal access nurse)

 

Scope of Service

Conditions out of scope

The following conditions are not routinely provided at Mater Hospital Brisbane:

View list of conditions:

  • Asymptomatic / cosmetic varicose veins

 

Conditions in scope

Aortic aneurysm

Essential information (Referral will be declined without this)

  • General referral information
  • Gentic factors and collagen disorder
  • Significant co-morbidities
  • Cardiovascular assessment
  • Current aneurysm size, AP or transverse diameter measurement last 6 months (if known)
  • Vascular risk factors
  • U&E FBC & coags results, BSL Lipid profile
  • CXR report
  • Abdominal USS

Additional referral information (useful for processing the referral)

  • Fine slice CT (if available) (patient to bring CD)

Other useful information for management (not an exhaustive list)

  • Advance health directive (where available)
  • AP and Transverse dimensions - Please note length of aneurysm is irrelevant
  • Atherosclerosis risk factor management (antihypertensive; diabetes, dyslipidaemia)
  • It is strongly recommended that people who smoke stop before surgery as it increases the complications of surgery and is associated with delayed skin healing.
  • Please consider directing your patient to a smoking cessation program.
  • Where serial/follow-up >3.5cm-5cm, 6-monthly surveillance USS is performed.
  • Where serial/follow-up <3.5cm, 12-monthly surveillance USS is performed.
  • Any increase of 1cm or more within a 12-month period is an indicator for early referral.
  • Driving should cease if AAA is >5.0cm or the patient is considered at risk of dissection or rupture  - Ausroads Assessing fitness to drive

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Abdominal aortic aneurysm  >5.0cm AP or transverse diameter measurement (increasing size, tenderness)

Thoracic aneurysm >5.0cm transverse diameter measure (increasing size, tenderness)

Rapid AAA expansion (>1.0cm / year)

Abdominal aortic aneurysm  4.0-5.0 cm - transverse diameter measure

Thoracic aneurysm 4.0-5.0cm - transverse diameter measure

Abdominal aortic aneurysm  <4.0cm - transverse diameter measure

Thoracic aneurysm <4.0cm - transverse diameter measure

 

Carotid artery disease

Essential information (Referral will be declined without this)

  • General Referral Information
  • Clinical history
  • History of TIAs (localising, amaurosis fugax) or stroke
  • History of risk factors and management
  • Type/location/timing of symptoms (contralateral sensory/motor, monocular visual change)
  • Cardiovascular assessment
  • USS, duplex scan  (carotid artery) results
  • BSL Lipid profile U&E FBC & coags Homocysteine level (HbA1C if diabetic)

Additional referral information (useful for processing the referral)

  • None

Other useful information for management (not an exhaustive list)

  • Advance health directive (where available)
  • Atherosclerosis risk factor management (antihypertensive; diabetes, dyslipidaemia)
  • Lifestyle modification (Increased activity, dietary, weight, smoking, alcohol)
  • It is strongly recommended that people who smoke stop before surgery as it increases the complications of surgery and is associated with delayed skin healing. Please consider directing your patient to a smoking cessation program.
  • Commence anti-platelet agent aspirin (clopidogrel if there is allergy or other contraindication to aspirin)
  • Active cholesterol and blood pressure lowering (if appropriate)

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – Urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Isolated TIA/stroke, amaurosis fugax

Symptomatic internal carotid stenosis of >50% on imaging

Asymptomatic internal carotid stenosis of >80% on imaging

Symptomatic <50% internal carotid stenosis

Symptomatic subclavian steal syndrome

Occluded internal carotid

Carotid body tumour

Asymptomatic carotid stenosis of between 50-79% on imaging

 

Dialysis access procedure (specialist to specialist referral)

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • USS report (optional)

Other useful information for management (not an exhaustive list)

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – Urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

A patient with a catheter insitu for dialysis who is awaiting an AVF formation

A patient currently on haemodialysis who has a failing AVF

Renal access referral prioritisation score >8

statewide renal access surgery: dialysis access referral form

Renal access referral prioritisation score 5-8

statewide renal access surgery: dialysis access referral form

Renal access referral prioritisation score <5

statewide renal access surgery: dialysis access referral form

 

Peripheral arterial disease

Essential information (Referral will be declined without this)

  • General Referral Information 
  • History including
    • incapacitating claudication distance
    • rest pain
    • ischaemic changes
  • Peripheral pulses: femoral/popliteal/foot
  • Risk factors particularly smoking and diabetes
  • Recent cardiac tests, including stress test results
  • Duplex USS scan results (Cat 1 case only)
  • U&E FBC & coags, BSL Lipid profile

Additional referral information (useful for processing the referral)

  • Homocysteine level (HbA1C if diabetic)

Other useful information for management (not an exhaustive list)

  • Advance health directive (where available)
  • Diabetic foot ulcer: High-risk foot clinic (referral via podiatry and access via telehealth available –  Statewide Diabetes Clinical Network will provide details)
  • Asymptomatic tibial disease should follow risk modification pathway and exercise therapy as first option
  • Atherosclerosis risk factor management (antihypertensive; diabetes, dyslipidaemia)
  • Lifestyle modification (Increased activity, dietary, weight, smoking, alcohol)
  • Graduate exercise therapy (as appropriate)
  • Commence anti-platelet agent (aspirin)

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to emergency if clinically indicated:

  • Threatened limb (ulcer, gangrene, rest pain)
  • Diabetic foot with ulcer with infection

Claudication <50m

Significant impact on quality of life

Peripheral aneurysm

Intermittent claudication with no signs of limb-threatening ischaemia >50m

Arm ischaemia with non-critical limb

Asymptomatic peripheral aneurysms below the treatment threshold

Claudication with no impact on quality of life

 

Venous disease

Essential information (Referral will be declined without this)

  • General Referral Information
  • History and examination findings in particular commenting on:
    • bleeding venous ulcer
    • venous ulcer
    • thrombophlebitis
    • DVT
    • lipodermatosclerosis
    • varicose eczema
    • previous surgery
    • details how varicose veins limit activity  (executing activities) and participation restrictions (involvement in life situations) e.g. standing long periods at work.
  • Conservative measures trialled
  • If peripheral arterial disease, please indicate if ulcers or ischaemic rest pain.
  • U&E FBC results
  • If history of DVT: ensure hypercoagulable screen and coag results

Additional referral information (useful for processing the referral)

  • USS mapping of varicose veins

Other useful information for management (not an exhaustive list)

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – Urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to emergency if clinically indicated:

  • acute DVT

Haemorrhage from varicose veins

Venous ulcer

Acute thrombophlebitis (clexane for 6 weeks)

Lipodermatosclerosis

Symptomatic varicose veins excluding cosmesis (Spider/cosmetic vein)

Chronic DVT

 

Other Vascular Condition

Essential information (Referral will be declined without this)

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

 

Our Specialists

Dr John Bingley

Director of Vascular Surgery, Vascular Surgeon

Dr Steven Gett

Vascular Surgeon

Dr Daniel Hagley

Vascular Surgeon

 

Bulk Billed Clinics

Mater Health offers patients the opportunity to attend bulk billed clinics. To provide your patient with the opportunity to attend a bulk billed clinic, please provide a named referral to one of the specialists listed above.

Contact Us

If you would like to discuss a referral, including clinical criteria, or update the status of a current patient please contact our priority GP phone line on 07 3163 2200 

Current Waiting Time for Appointments

We provide up to date data on how long patients are waiting for their first appointment by specialty here.

Referral Guideline Development

These Mater Referral Guidelines align with standardised best practice tools for referral to publicly funded specialist outpatient services developed in Queensland through the Clinical Prioritisation Criteria project. 

 

Content last reviewed: 16 February 2018

 

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