Vascular surgery

Our private Vascular surgery services are provided at the Royal Free Hospital, Hampstead and Hadley Wood Hospital, High Barnet.

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Blood is pumped away from the heart in arteries and returns via the veins. This ‘circulatory system’ is essential for providing organs with essential oxygen and other nutrients they require to function.

Problems arise when blood cannot flow smoothly through this system. Vascular surgery is a branch of medicine that specialises in the diagnosis and treatment of blood vessel disorders. Vascular surgeons are the experts that specialise in providing a range of treatments, including surgery, to maintain the function of the body’s circulatory system.

Vascular Surgery at the Royal Free Hospital Private Patients Unit

Here at the Royal Free Hospital Private Patients Unit (PPU) we offer a wide array of vascular services, provided by our multidisciplinary team of leading specialists. The PPU combines the convenience, comfort and personalised attention of a private hospital with the very best state-of-the-art services, technology and professional experience expected from a top London NHS teaching hospital.

We are unique in that all of the profit that is made each year is reinvested back into the NHS services at the Royal Free Hospital trust, and this contributes to the world-class care that our hospitals provide.

Conditions we treat

Our specialists and their teams are trained to provide a high standard of care for a variety of vascular problems, including:

Peripheral Arterial Disease (PAD)

This describes a narrowing of the arteries supplying the limbs due to build-up of fatty deposits or ‘atheroma’. It usually develops in the legs, initially causing pain when walking, known as claudication, but can progress to rest pain, ulceration and even gangrene. PAD commonly affects people over the age of 50 years, occurring in up to 1 in 5 men and 1 in 8 women within this age group. Smoking, high blood pressure, high cholesterol and, in particular, diabetes are major risk factors.

Abdominal Aortic Aneurysm (AAA)

This is a condition of the aorta (the main artery from the heart that runs through the chest into the abdomen). An aneurysm occurs when a weakness in the wall causes the artery to enlarge due to the constant pulsatile pressure inside. This is often painless and unsuspected, but is at risk of enlargement and rupturing. In the UK, a national screening programme for AAA is offered to men aged over 65 years.

Varicose Veins

These are sections of veins just beneath the skin that lose their elasticity and become dilated with time. In many people, they are often unproblematic but unsightly and uncomfortable. However in some, severe varicose veins cause pain, skin changes, ankle ulceration or bleeding.

Deep Vein Thrombosis (DVT)

DVT is caused by a clot within a vein, usually in the leg. It occurs when blood is static for too long due to a period of immobility, such as following surgery or on a long-haul flight, or in situations where the blood is prone to coagulation. People over the age of 60 years and some pregnant women are at the greatest risk.

Cerebrovascular Disease

This is caused by a disruption of the blood supply to the brain. It may be temporary and resolve, in what is known as a Transient Ischaemic Attack (TIA). In more serious cases, a stroke can occur, which frequently results in irreversible brain damage if not treated urgently. Strokes can be quickly recognised by using the acronym FAST: Facial weakness, Arm weakness, Speech problems, Time to call 999.

What we offer

Our vascular surgeons are trained to perform a wide array of treatments and procedures, in conjunction with our expert multidisciplinary team of specialists:

Avulsion treatment for varicose veins

Minimally invasive varicose vein treatment (EVLT)

Pelvic vein embolisation

Thread vein treatment/Sclerotherapy

Varicocele treatment

Venous leg ulcers

Abdominal Aortic Aneurysm Repair

This is performed to prevent an aneurysm rupturing and involves replacement of the diseased aorta by an artificial graft. AAA repair can be performed as an ‘open’ procedure, which involves opening the abdomen. Alternatively a keyhole or ‘endovascular’ procedure replaces the diseased aorta with a stent graft from within the artery through only small cuts in each groin. Endovascular aneurysm repair (EVAR) is less invasive and recovery is faster, but there is a low risk of later complications after placement. Our specialist experts will discuss with each individual patient the most appropriate treatment options for their care and are able to answer any questions on the procedures.

Thoracic Endovascular Aortic Repair (TEVAR)

Angioplasty

Carotid/Femoral Endarterectomy

Bypass Grafts

An alternative to angioplasty is to bypass the diseased section of artery by sewing an artificial ‘graft’ into the vessels above and below the blockage, creating a new clear route for blood to flow through. Different types of bypass are used depending on the location of the blocked artery:

Axillo–bifemoral bypass runs from the axillary artery, under the collarbone, to the right and left femoral arteries in the top of the legs
Fem-distal bypass graft restores blood flow from the femoral artery, which provides the main bloody supply to the leg, to the distal arteries further down in the calf and lower foot
Fem-fem crossover graft connects both femoral arteries to bypass a blockage on one side. For example, a blocked right femoral artery can be connected to a healthier left femoral artery thereby improving blood flow to the right leg
Ilio-femoral bypass is used for a blockage in one of the two iliac arteries. These branch from the aorta and become the femoral arteries. The procedure joins the healthier iliac artery to the femoral artery on the opposite, blocked side
Ilio-profunda bypass runs from the iliac artery to another important artery in the leg, the profunda femoris
Carotid subclavian bypass is used to restore blood flow to the subclavian artery, which supplies the arm, using the carotid artery in the neck

Our specialist teams will be able to identify the most suitable procedure for each individual patient and can offer information and support throughout.

Embolectomy/Thrombectomy

Varicose Vein Surgery

If varicose veins are problematic or unsightly and not resolving with conservative measures, such as compression stockings, they can be treated with surgery. This can either be done using a heat source to close the vein (laser or radiofrequency ablation) or injecting a medicine that causes the vein to shrink (sclerotherapy). There are many other procedures and techniques available and the specialists will discuss these with each patient.

Arteriovenous Malformations (AVMS)

Meet our consultants

We work with leading experts who are all supported by the expertise of a multidisciplinary team. Our specialist team of doctors and surgeons includes:

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