Conditions we treat
Problems with the circulation to the limbs
“Peripheral arterial disease” is a condition in which a fatty deposit (atheroma) builds up within the arteries one or more limbs, most commonly affecting the leg. This leads to narrowing or blockage of the artery, which in turn leads to impairment of the blood supply to the affected limb. This can cause pain when walking (intermittent claudication), or, more seriously, to severe circulation problems ultimately requiring intervention to prevent amputation. Many such blockages can be managed by endovascular means, by stretching the artery or inserting a “stent” (a wire mesh cylinder to help keep the artery open), although some will require a surgical operation to “bypass” the blocked artery.
Narrowing of the Internal Carotid Artery
Atheroma can also build up in the arteries supplying the brain (the internal carotid arteries). This is known to be a common cause of stroke, and often presents with a temporary “ministroke” more properly referred to as a Transient Ischaemic Attack. This takes the form of temporary weakness affecting one arm, one leg, or both an arm and a leg (but both on the same side of the body). Alternatively, there may be temporary speech difficulties or transient vision loss in one eye. Such an event does suggest that there is a high risk of imminent stroke and requires urgent investigation and treatment. Whilst treatment is often by medication and changes in lifestyle, more severe narrowings are treated by an operation to remove the diseased inner layer from the artery (carotid endarterectomy).
Abdominal aortic aneurysm
An aneurysm is a weakening of an artery due to deposition of a fatty deposit (atheroma) within its wall. This causes stretching and ballooning and renders the artery in danger of bursting. This most commonly affects the main artery in the abdomen (the abdominal aorta). Aneuryms can be repaired by an open operation to replace the weakened artery, or, in many cases, insertion of an artificial artery (stent-graft) by endovascular means (ie from inside the artery through small groin incisions). This latter procedure is known as EVAR (endovascular aneurysm repair), and is now the commonest method for repairing aortic aneurysms.
This is an extremely common condition which results in distension of the superficial veins of the leg due to faulty one way valves, impairing the vein's ability to drain the blood adequately. This can cause leg pain, skin changes or even ulcer formation. Most varicose veins nowadays can be treated by a simple procedure normally done under local anaesthetic.
Leg ulcers are common, particularly in elderly people, and may be due to problems with the veins, the arteries or both. Whilst many ulcers can be managed at home, some require further investigations and surgery or endovascular treatment to help the ulcer to heal.
Injury to major blood vessels is a serious potential complication of major road traffic accidents which can result in bleeding or impairment of blood flow to an organ or limb. This often requires surgery or endovascular treatment to repair the damaged artery or vein.