Tel: 021 637 0935 Gatesville Melomed: Suit 2, Block A, 3rd Floor.
Vascular and Endovascular surgeon at Gatesville Melomed Hospital
Practice number 042001 0197467
Dr Duncan Anderson
Working with you
Abdominal Aortic Aneurysm
An abdominal aortic aneurysm is the removal of a weak and swollen part of the major blood vessels which comes off your heart and feeds all the abdominal organs and lower limbs. The weakened damaged part of the abdominal aorta is then replaced with an artificial graft.
​
This operation can either be an emergency; when the aneurysm leaks or ruptures. This is a life-threatening event and if not operated on immediately will result in death. Should the aneurysm be found early, it is often monitored until large enough to warrant surgery. This can either be done as an open repair using an artificial graft or a special device can be placed into the aorta. The device is called an EVAR or FEVAR and there are different types of devices depending on where the aneurysm is.
​
This operation has significant risks and possible complications. For more in-depth information regarding the open repair or an aortic aneurysm, please press the button below.
Angiogram
An Angiogram is a procedure which is typically done in a Cath Lab (mini theatre), where contrast (a dye) is injected into your bloodstream via a needle inserted into your groin. This enables your surgeon to be able to take x-rays of the blood flowing through your blood vessels and determine where the narrowing's or blockages to your bloodstream are. Your vascular surgeon will use this information to insert a balloon (angioplasty) to widen the narrowing and possibly also insert a stent to keep the blood vessel open to allow blood flow back to your limb.
This procedure is generally done under local anesthetic to prevent pain (but you will be awake and not asleep). You will be required to stay in hospital over night and lie on your back for 12 hours after the procedure to prevent bleeding. For more in-depth information regarding this procedure, please click on the button below.
Post operative wound care
Most wounds after surgery will be sutured closed. In rare circumstances there might be too much tissue loss to allow the wound to be closed during the operation. A wound may also be left open or opened post-surgery to allow a collection of pus, blood, or serous fluid (wound fluid) to drain. You will be referred to a wound care specialist to assist you with caring for your wound once you have been discharged.
Simple sutured post-surgical wounds are best left alone for at least 1-2 weeks after surgery. If the plaster remains clean, leave the plaster in place and remove when the surgeon or wound care sister has told you to do so. Most vascular post op surgical wound's sutures or clips are usually kept in place for 10-14 days. Should the plaster fall off, wash the wound gently with soap and water, dry well and leave open unless it is likely to become dirty; in this scenario, you will need to cover the wound with dry clean gauze to keep it clean.
Other factors may also increase the length of time your sutures or surgical clips need to remain in place. These include a history of diabetes, smoking, poor blood supply and use of certain medications such as cortisone. These factors delay wound healing and may require the sutures to stay in longer. Please contact the rooms should you not receive a follow up appointment on discharge - 021 637 0935 or via email: vascularsurgeon.capetown@gmail.com.
​
Should your wound become painful, red, swollen or have a discharge once you have been sent home, please contact our rooms for an urgent follow up appointment.
​
Renal Access Surgery for Haemodialysis
Haemodialysis is one of two options for patient whose kidneys have stopped functioning properly. Renal failure prevents toxins from being removed from the body and results in water and electrolyte imbalances. Patients who have entered renal (kidney) failure may require planned or emergency surgery.
A Hickman catheter is inserted as an urgent line to allow haemodialysis to be performed, by allowing your blood (now filled with toxins and too much fluid) to be linked to the haemodialysis machine which will remove excess fluid, correct some of the salt imbalances and remove toxins. This is done until a fistula (long term haemodialysis access) can be surgically planned.
​
Should you have any further queries, please do not hesitate to ask Dr Anderson during your consultation. A more detailed explanation can be obtained by clicking the button below.
Surgery for Strokes
Carotid enterectomy
Carotid surgery is performed for a narrowing of the carotid artery (the main arteries that provide oxygenated blood to the brain). This surgery is usually only offered if there is a significant narrowing of the carotid artery associated with a recent stroke. Unfortunately, many narrowings are only picked up after a cerebral vascular accident (stroke) or symptoms of a Transient Ischemic Attack (TIA) has occurred. As the narrowing worsens, there is a greater risk of having a stroke or TIA.
The surgery is mostly performed on awake patients with local anaesthetic as it is safer, however it can also be done under general anaesthesia (when you are asleep). The advantage of being awake is that although you will be sleepy and feel relaxed during the operation, you should not feel any pain, except possible pressure. However, the surgeon and anaesthetist will be able to monitor you during the procedure by asking you questions and testing your hand grip strength, which will alert them early should there be any reduction in blood flow to your brain and allow them to put in shunts or other devices to increase blood flow to the brain during the surgery.
​
The affected carotid artery is opened, and the build-up of plaque (fats and other substances which cause atherosclerosis) which narrows and finally may block the carotid artery is surgically removed. When the blood flow becomes critically narrow or a piece of the plaque breaks off, it gets lodged in a smaller artery within the brain. The result may be a cerebral vascular accident (stroke) or Transient ischemic attach (TIA); mini stroke.
The surgery has an excellent success rate, however, there are also many possible complications. These include a CVA or TIA, heart attack, nerve problems, seizures, bleeding into the brain, infection and a blocked airway from swelling or bleeding in the neck. Therefore, this surgery should never be taken lightly. Most healthy patient are able to go home after 1-2 days post operatively.
Should you experience any of the following symptoms at home, call for an ambulance immediately. A sudden, severe headache, slurred speech or sudden difficulty in talking, difficulty seeing with one or both eyes or any loss of feeling or weakness on one side of your body or face.