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Vascular Surgery

Find assessment and management information on Vascular Surgery conditions at:

Emergency Immediate transfer to the Emergency Department

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

  • 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)
  • Active infection in leg with peripheral arterial disease
  • Diabetic foot infection (refer to high-risk foot pathway)
  • Acute arterial ischemia/threatened limb
  • Ischemic changes and/or threatened limb (ulcer, gangrene, rest pain)
  • Diabetic foot with ulcer or infection
  • Foot ulcer with infection and systemically unwell or febrile, invasive infection or rapidly spreading cellulitis (defined by peripheral redness around the wound >2cm), acute ischemia, wet gangrene, acute or suspected Charcot 
  • Axillary vein thrombosis, iliofemoral DVT
  • Acute DVT
  • Thrombosed AVF

Arterial/ischaemic ulcer

  • Systemic inflammatory response symptoms (SIRS) or clinically unwell
  • Worsening pain and/or pain not in keeping with progression of the wound/ulcer
  • Sepsis or acutely unwell due to infection
  • Acute or critical limb ischaemia with necrosis
  • Rapidly deteriorating ulceration or necrosis
  • Ulcers or wounds in a limb with markedly compromised circulation

High Risk Foot

  • Acute/Critical limb ischemia and non-palpable pulses or necrosis – Refer directly to  Princess Alexandra Hospital Emergency (PDF, 477.27 KB)urgently
  • Systemic inflammatory response symptoms (SIRS) or clinically unwell
  • Worsening pain and/or pain not in keeping with progression of the wound/ulcer
  • Progressive cellulitis despite initial treatment (defined by peripheral redness around the wound > 2cm)
  • Acute Charcot arthropathy if access to podiatry is not accessible within 48 hours
  • Wet gangrene

Are you referring to the right service?

Urgent referrals Arranging urgent review

To arrange a very urgent outpatient appointment, please phone the relevant hospital’s switchboard and ask to speak to the Registrar on call of the relevant specialty. 

For the following conditions please make urgent referral by calling the Vascular Surgery Registrar at PAH:

  • Immediate threat to life, limb 
  • Wound infection post vascular surgery
  • Acute bypass graft occlusion
  • Carotid disease causing TIA

Out of scope services

The following are not routinely provided in a public Vascular Surgery service.

  • Asymptomatic / cosmetic varicose veins
  • Leg pain with tibial vessel occlusions in non-diabetic patients


  • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service.  Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
  • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
  • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Out of catchment

Metro South Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service.  If your patient lives outside the Metro South Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

Last updated 21 July 2021