COVID-19: Vascular service guide

Updated: November 2020

Scope

This information provides guidance on the management of vascular patients across Western Devon during the Covid-19 pandemic. The information is based on the Vascular Society recommendations.

Urgent advice

Please call the on-call vascular surgeon (available 24 hours) via University Hospitals Plymouth Switchboard: 01752 202082

Urgent vascular referrals include:
  • acute limb ischaemia
  • suspected ruptured abdominal aortic aneurysm (AAA)
  • diabetic foot sepsis requiring admission

Urgent referrals

Critical limb ischaemia (rest pain and tissue loss)
  • will be considered for revascularisation
Symptomatic carotid stenosis (e.g. amaurosis fugax, transient ischemic attack (TIA), cardiovascular event (CVE))
  • will be considered for endarterectomy
  • many will be managed with best medical therapy only
Abdominal Aortic Aneurysm (AAA)
  • will be considered for treatment on a case by case basis (as is currently the case, e.g. if meet size criteria or symptomatic)
  • current guidance for urgent referral is greater than 4.4cm. However, the size threshold for surgery may be significantly higher than this and needs to weigh up risk of rupture in the next few months with risk of intervention and resource limitation.
  • Abdominal Aortic Aneurysm (AAA) Clinical Referral Guideline:
Varicose Veins with significant bleeding

Risk factors for face-to-face review will be decided on case by case basis.

Routine referrals

  • Asymptomatic carotid stenosis
  • Intermittent Claudication
  • Varicose vein surgery without significant bleeding

Patients can be signposted to the below site for information and advice on these and other common vascular conditions:

Circulation Foundation - Patient Information

All new routine referrals will be clinically triaged and will either be added to a waiting list or, if appropriate, A&G will be given.

Please ensure that a practice-based system is in place to check daily for returning referrals with A&G.

Prior to making a routine referral, please ensure that any appropriate Policy or CRG has been reviewed and that all the suggested investigations and management options have been considered.

Existing new and follow-up routine appointments have been cancelled and changed to telephone / video consultation where appropriate.

COVID-19 High risk patient advice

Vascular emergencies in the presence of symptoms of COVID 19 will be assessed and tested along hospital guidelines in A&E at Derriford.

Devon Vascular contact information

Contact the Vascular Surgeon on-call through University Hospitals Plymouth switchboard: 01752 202082

Patient information

MyHealth - Varicose Veins

Pathway group

This guideline has been signed off by Vascular at University Hospitals Plymouth on behalf of the NHS Devon Clinical Commissioning Group.

Publication date: April 2020

Last updated: 06-11-2020

 

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