Patient Journey
Professor O’Donnell receives Private Healthcare Referrals at the
Kingsbridge Private Hospital Belfast
,
Kingsbridge Private Hospital North West
,
Kingsbridge Newry Clinic
,
Ulster Independent Clinic
and coming soon -
Orthoderm Clinic
in Hillsborough from patients throughout Northern Ireland and Ireland for all remits of primary and complex arterial, venous and lymphatic diseases.
Professor O’Donnell believes that communication and its ability to reduce a patient’s stress is absolutely paramount in clinical practice. This part of the web-page describes the complete patient journey from initial referral through to definitive treatment and subsequent follow-up.
Each aspect of the journey is discussed separately and a video presentation has also been included for one of the procedures that Professor O’Donnell performs frequently – Endovenous Radiofrequency Ablation of Varicose Veins (recorded in 2019 when working as an NHS Consultant in the Belfast Trust).
VIDEO
Initial Consultation
Professor O’Donnell will endeavour to make you feel at ease during your consultation. At this stage, you will be asked about your current symptoms and how they affect you.
It is important to inform Professor O’Donnell about any pre-existing medical conditions you may have or other medical factors you feel may be important during this consultation.
An up-to-date prescription list of all your current medications and allergies is appreciated.
Clinical Assessment
Depending on your clinical complaint, Professor O’Donnell will need to examine the affected area.
Patients with an aortic aneurysm will require an examination of their abdomen, groin pulses and feet.
Patients with varicose veins and peripheral arterial disease will require a full examination of their lower extremities and will need to remove trousers, socks and shoes. Underwear does not need to be removed. A gown or surgical drape will be provided to protect modesty.
The examination may then be completed with you lying on the examination couch, in the standing position or both.
Investigations during your Initial Consultation
Professor O’Donnell believes in a unique treatment plan for each individual patient which is guided by the completion of clinic based investigations during your first consultation.
All aspects of your clinical assessment and diagnosis will be discussed with you during this initial consultation. Professor O’Donnell will advise accordingly if further investigations are then required before a definitive treatment plan can be determined.
Varicose Veins
In patients presenting with varicose veins, a bedside venous duplex is performed. This requires the application of ultrasound gel, similar to a pregnancy scan, and passage of the ultrasound probe over the varicose veins to identify venous anatomy particularly the size of the vein and whether it is incompetent – leaky. This is a painless examination.
In certain circumstances, a formal venous duplex is required in the radiology department particularly if you have had previous varicose vein procedures or if you have had a history of a deep venous thrombosis (DVT).
Watch on YouTube
Venous Duplex Examination
Peripheral Arterial Disease
In patients presenting with walking difficulty or other symptoms suggestive of peripheral arterial disease, an ankle-brachial pressure index will be performed.
This is another painless examination which evaluates the measurement of the pressure of blood supplying the lower limbs compared to the upper limbs and provides an indication of disease severity. This requires the application of a blood pressure cuff which is inflated while Professor O’Donnell listens to the audible blood flow signal using an Arterial Doppler Scanner.
Watch on YouTube
Ankle-Brachial Pressure Index Evaluation
Additional Vascular and Radiological Investigations
Aortic Aneurysm
Patients presenting for investigation of an aortic aneurysm will require an abdominal ultrasound. A separate appointment in the radiology department will be required to perform the ultrasound test which Professor O’Donnell will request on your behalf.
If the ultrasound identifies that you have an aortic aneurysm greater than 5.5cm, you will be referred for a CT angiogram scan of your aortic aneurysm. You may require a blood test prior to this scan to evaluate your kidney function and to determine if the CT scan can proceed safely. You may also be asked by the radiology department about some of your medications at this stage particularly if you take metformin for diabetes.
The hospital radiology team members performing the CT angiogram will need to insert an intravenous cannula in one of your arms to facilitate the injection of intravenous contrast which is required to highlight or emphasise the blood flow in the aneurysm during the scan to better evaluate it. The CT scan itself is painless and is performed very quickly.
Watch on YouTube
CT angiogram demonstrating an aortic aneurysm
Cerebrovascular Disease
Patients presenting for investigation of cerebrovascular disease where they may have had a mini-stroke (TIA) or full stroke will require an ultrasound scan of the neck artery to assess for significant narrowing (stenosis). Sometimes further investigation with a CT angiogram of your carotid artery is also required.
VIDEO
Procedural Planning
After your clinical evaluation and completion of subsequent investigations, Professor O’Donnell will discuss your clinical condition with you and will present the available treatment options. If an intervention is recommended, the benefits and risks of the suggested procedure will be discussed as part of the initial Informed
Patient Consent
process. This is a legal requirement prior to proceeding to the intervention or therapeutic procedure.
Procedural risks for the range of therapeutic interventions that Professor O’Donnell performs can be found on the
Treatments section of this web-site
.
You do not have to commit to any specific procedure at this stage. You can arrange a review appointment to discuss any issues you have prior to committing to any procedure. At this stage if you are attending as a privately insured patient, you will need to contact your Medical Insurance Company for approval for the required procedure. Once you have approval, please contact the relevant hospital and advise them accordingly. Information regarding Private Medical Insurance can be found on the
Consultations section of this website
.
Professor O’Donnell performs all aspects of vein surgery at both the
Kingsbridge Private Hospital Belfast
and
Kingsbridge Private Hospital North West
. For the rest of this webpage section, Professor O’Donnell will describe the clinical pathway for patients requiring Endovenous Management of Varicose Veins. Clinical pathways may vary for each different condition that Professor O’Donnell treats.
All other aspects of vascular conditions that Professor O’Donnell assesses are described in the
Treatments section
.
Professor O’Donnell no longer performs endovascular arterial procedures or open arterial operative surgeries. Due to the complexity of arterial surgery which is indicated for the prevention of strokes, aortic aneurysm rupture or to improve lower limb blood supply, such procedures or surgeries are not currently performed privately in Northern Ireland. Further information for these conditions and procedures is available in the
Patient Information section of this web site
.
Day of Procedure
Once you have been scheduled for your procedure, the relevant hospital will inform you of all required details regarding your attendance.
Local anaesthetic vein procedures do not require a period of fasting. Although you should be able to take all of your normal medications, it is important that you have previously informed Professor O’Donnell and the hospital where you are having the procedure of your current medication prescription particularly blood thinning medications.
General anaesthetic procedures do require a period of fasting. Your surgical and anaesthetic teams will need to review your medications and determine which of your regular medications you should take on the day of your surgery.
Professor O’Donnell will examine you prior to your procedure to address any questions you may have and confirm the specific treatment you will undergo. At this stage, all aspects of the procedure will be discussed and you will be requested to confirm your agreement by signing the consent form.
Specific risks and complications of all procedures are available for review on the
Treatments section
of the web page. Further information may be obtained from the
Patient Information
section as well.
Finally your lower extremity varicose veins will be marked. You will be asked to look at the marked areas on your lower limbs to confirm inclusion of all the areas that you wish to have treated.
Endovenous Management of Varicose Veins
Video presentation by Professor O’Donnell describing individualised treatment of varicose veins using endovenous radiofrequency ablation combined with additional adjuncts of injection sclerotherapy and microphlebectomies as required (recorded in 2019 when working as an NHS Consultant in the Belfast Trust).
VIDEO
Post-Procedural Instructions
Professor O’Donnell has designed post-operative instruction booklets which can be downloaded here directly for each of the specific procedures her performs.
In summary, following your procedure, your treated limb will be lavaged. Small paper stitches (steri-strips) and adhesive dressings are placed on your treated lower limb by Professor O'Donnell's nursing team. There are no stitches used.
Compression hosiery (stockings) are then applied over the dressings to your treated limb which are used to improve your clinical outcome following your intervention and reduce the risk of thromboembolic complications. These stockings can be slightly challenging to put on initially due to their snug fit – however this is exactly what we want. However, they do loosen slightly after the first 48-hours making it easier for you to re-apply them.
Professor O’Donnell may also apply an extra layer of compression bandaging over the compression stockings called “Peha-Haft” for the first 48-hours. This can be simply removed by you after 48-hours and disposed.
All matters relating to post-operative care following your procedure with Professor O'Donnell are included in his personally designed post-operative patient information leaflets which are free to download above from this webpage.
The British Association of Sclerotherapy has also produced patient resources for patients undergoing
Foam Sclerotherapy
and
Microsclerotherapy
.
Post-Procedural Contact Phone Numbers
If you have an urgent concern or problem relating to your recent procedure, please contact the relevant hospital where you had your procedure completed.
Post-Procedural Follow-Up
A follow-up appointment will then be scheduled for you depending on your clinical presentation and the specifics of your procedure.
Routine post-operative appointments are normally provided between 6 weeks and 12 weeks after your procedure. However, if there are any issues prior to your scheduled post-operative clinic review, please contact the relevant hospital or Professor O’Donnell directly at
info@markodonnellvascularsurgery.com
.
Phone: 0771 4227 627
