January 21, 2020

Northern Health hosts third annual Complex Venous Workshop

The Northern Health vascular surgery team were pleased to host their third annual Complex Venous Workshop last Wednesday.

Workshops involve treating cases of patients with complex venous disorders, and hosting renowned venous experts from around the globe, for an opportunity to share expertise and learn from world-leading surgeons.

“This year, we had the honour of hosting Melbourne surgeon, Professor Michael Grigg, to join us and share his invaluable experience. The focus of the workshop was thoracic outlet compression and, once again, a case of complete vena cava obstruction,” said Iman Bayat, Head of Vascular Surgery at Northern Health.

Professor Grigg led the first case of the workshop – a cervical rib resection to treat thoracic outlet syndrome.

The thoracic outlet is a narrow space between the collarbone and first rib. Through this narrow space, large vessels and nerves travel from the chest and neck into the arms. In some patients, these vessels and nerves can be compressed and result in complications such as blood clots or damage to the vessels.

Treatment for these patients is not only to treat the immediate complications such as blood clots, but to prevent recurrence of the complications by removal of the first rib. Interestingly, our patient who underwent treatment during the workshop not only had compression by the first rib, but also had an extra rib, which is a known but rare congenital anomaly.

The patient underwent successful surgery by Professor Grigg and Northern Health surgeons, Mr David Goh and Mr Shrikkanth Rangarajan.

“The workshop today was excellent. It’s a very pleasant environment here and the theatres are extremely well equipped,” said Professor Grigg.

The second case, led by Northern Health surgeons, Mr Iman Bayat and Mr David Goh, successfully opened an obstructed inferior vena cava (IVC) and iliac veins using balloons and stents.

“In our efforts to treat the more complex of the spectrum of chronic venous obstruction, our second case was a patient who had blockage of her inferior vena cava from previous, and now in remission, cancer,” Mr Bayat said.

“The IVC is the main vein in the abdomen that transports the returning blood from both legs and the pelvic organs back to the heart. With this vein being completely blocked, our patient unfortunately suffered from pain in the legs while walking, leg swelling, and, if not treated, would have developed further complications such as ulcerations and skin changes. The procedure was successful with no complications,” Mr Bayat added.

“It was just over a year ago when we performed the first endovascular IVC reconstruction with guidance from Mr Stephen Black visiting from the UK, and it’s great to see the skills acquired at these workshops enable our surgeons to now tackle these more complex procedures and bring those benefits to our patients,” Mr Bayat said.

Northern Health vascular surgeons are leading the state in treating complex venous disease and are working towards offering a complete spectrum of venous care to patients in the north.

Featured Image: Mr Iman Bayat, Head of Vascular Surgery at Northern Health (centre) and Professor Michael Grigg (far right middle row) with Northern Health staff