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Vascular surgery is the treatment of diseases of arteries and veins (except the heart).
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About Vascular Surgery
The 2 commonest problems I see are varicose veins or blockages in the arteries (due to atherosclerosis), these conditions are very different.
Varicose veins occur when the valves in the veins in the legs are not working properly, leading to the veins becoming tortuous and enlarged. They can cause a wide range of problems but often cause no symptoms at all. Symptoms encountered include ache, discomfort, swelling, skin damage, eczema, leg ulcers or bleeding.
Blockages or narrowing in arteries are often related to smoking, diabetes, kidney disease, age, high cholesterol and high blood pressure. Most people are well aware of the problems this can cause in the heart (heart attack or angina) or in the brain (strokes). Blockages in the arteries to the legs typically cause a cramp like pain in either the calf or thigh when walking (this is called claudication). More advanced disease can lead to constant pain in the toes or heel, often in bed at night, foot ulcers or gangrene.
What to expect at your appointment: Varicose Veins
Mr Baroni will take a full medical history regarding your veins and any previous treatment. You will then need an examination of the abdomen (tummy) and the legs. Most patients will then have an ultrasound scan to assess the pattern of disease and to plan the most appropriate treatment.
For the vast majority of patients it will then be possible to discuss treatment options and plan intervention. Most procedures offered can be performed under local anaesthetic as a daycase.
Some patients who have had extensive previous surgery or deep vein thrombosis will need a more detailed scan by a consultant vascular radiologist and they will need to return for a further appointment to discuss treatment at a later date.
What to expect at your appointment: Arterial disease
Mr Baroni will take a full medical history regarding your symptoms and any previous investigation or treatment. You will then need an examination of the arms, abdomen (tummy) and the legs.
For the patients with evidence of arterial disease it is likely that further imaging tests will be needed such as MRI or CT scans. These can be requested and results discussed at a follow up appointment.
Varicose Vein Treatments
Most varicose veins can be treated with a key-hole technique such as Radiofrequency Ablation (VNUS) or Endovenous LASER (EVLA). These procedures seal the main problematic vein with heat. The vast majority of these will be performed under local anaesthetic, usually as a daycase. Occasionally more traditional open surgery is required, usually under a general anaesthetic. After treatment you can expect to be in a bandage or stocking for 7-10 days
Pre-procedure
10 days later
6 weeks following procedure
About Mr Baroni
Mr Baroni trained at St Bartholomew’s Hospital Medical College, qualifying in 1997. The first part of his specialist training was in London and Essex followed by two years as senior registrar at the Leeds Vascular Institute based at the Leeds General Infirmary. After completion of his general surgical and vascular training he was appointed to a one year endovascular fellowship, to obtain further experience in advanced endovascular and endovenous techniques as well as vascular ultrasound.
Along the way he has acquired an interest in both medical education and surgical training. He was previously the training programme director for vascular surgery in Yorkshire and is now a member of the Specialist Advisory Committee (SAC) for Vascular Surgery. He is an examiner for both the European Board of Vascular Surgery and the Intercollegiate FRCS (vascular) exam. He sits on the Vascular Surgery Speciality Board of the Royal College of Surgeons of Edinburgh and is an elected council member of the Vascular Society of Great Britain and Ireland.
In his spare time he enjoys ancient history, skiing and the Yorkshire countryside.
Consultation Times
Nuffield York: Tuesday pm
Nuffield Tees: Thursday am
Specialties
Vascular Surgery
Qualifications
BMed Sci, MB BS, FEBVS, FRCSEd, PG Cert (Vasc US), PG Dip (Med Ed)
GMC number: 4413446
Practicing since: 1997