Mater Private Specialist Quick Find

Vascular Surgery – public referrals

Clinical Lead - Dr Daniel Hagley

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

Catchment criteria applies for referrals for this service. Patient referrals from outside the Mater SEQ Catchment (which includes Metro South and West Moreton Hospital and Health Services) may not be accepted.

Mater Vascular Surgery treats a full range of vascular and related conditions, including aneurysm, carotid and peripheral vascular diseases, high risk diabetic foot disease (in a multi-disciplinary team setting), venous and lower limb ulcerative diseases and other vascular conditions. Mater has an efficient, high quality vascular service that uses both endovascular and open operative management where appropriate. We have expertise in wound care and we partner with community nursing and patients effectively. Where suitable we use Telemedicine to make consultation easier for distant and nursing home patients.

How to send a referral

 

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 stroke
  • Acute aortic dissection
  • Ruptured AAA
  • Symptomatic AAA (abdominal/back pain/tenderness, compressive symptoms, distal embolisation)
  • Axillary vein thrombosis, iliofemoral DVT
  • Acute DVT
  • Active infection in leg with peripheral arterial disease
  • Diabetic foot infection (refer to high-risk foot pathway)
  • Acute arterial ischemia/threatened limb
  • Ischaemic changes and/or threatened limb (ulcer, gangrene, rest pain)
  • Active infection in leg with peripheral arterial disease
  • Diabetic foot infection (refer to high-risk foot Healthpathway)
  • Foot ulcer with infection and systemically unwell or febrile, invasive infection or rapidly spreading cellulitis (defined by peripheral redness around the wound >2cm), acute ischaemia, wet gangrene, acute or suspected Charcot - A
  • 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)

  • Refer to Healthpathways or local guidelines
  • 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)

  • No additional information

Other useful information for management (not an exhaustive list)

  • Refer to Healthpathways or local guidelines
  • 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

Symptomatic occluded internal carotid

 

Asymptomatic internal carotid stenosis of >80% on imaging

Symptomatic <50% internal carotid stenosis

Symptomatic subclavian steal syndrome

Asymptomatic 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

 

High risk foot (vascular)

 

At the Mater Hospital Brisbane, High Risk foot is managed by The Queensland Diabetes and Endocrine Centre (QDEC). Please refer to their page for referral guidelines and naming specialist. 

 

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)

  • Refer to Healthpathways or local guidelines
  • 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 peripheral arterial disease especially tibial artery stenosis or occlusion when the foot is healthy and the symptoms are proximal to the lesions in non-diabetic patients, do not warrant referral and can be managed conservatively with risk factor modification and exercise therapy.  Other causes for the more proximal leg pain should be sought.
  • Atherosclerosis risk factor management (antihypertensive; diabetes, dyslipidaemia)
  • Lifestyle modification (Increased activity, dietary, weight, smoking, alcohol)
  • Claudication with no impact on quality of life should be managed conservatively with risk factor control, graduate exercise therapy and anti-platelets

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

Peripheral aneurysm above the treatment threshold

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

Asymptomatic peripheral aneurysms below the treatment threshold

Significant impact on quality of life

Asymptomatic upper limb arterial disease

 

 

 

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

 

How to refer

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

Referrals can be sent by:

Smart Referrals

Digital referrals in your practice software that include templates linked with referral criteria for quality handover for any public hospital

SmartForms

Cloud solution in your practice software that eliminates the need for template management

Secure messaging

Medical Objects:   HM4101000R8

HealthLink EDI: materref     

Fax         07 3163 8548

For fax and secure messaging our latest Mater Adult Referral Form or Antenatal Form are available to  embed into most major Practice Management software systems.

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: 13 December 2023

 

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