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Auckland Vascular & Varicose Vein Clinic - Dr Peter Vann

Private Service, Vascular Surgery, General Surgery

Today

9:00 AM to 5:00 PM.

Description

Dr Vann was the first New Zealand surgeon to obtain the FRACS (Vascular Surgery) by examination; he trained under the tutelage of vascular surgeons who worked with Professors Michael DeBakey & Stanley Crawford. He is currently one of the most senior Vascular Surgeons in Auckland with 25 years experience. 

Dr Peter Vann worked with Professor Sir Peter Bell (UK, pioneer vascular surgeon), Professor Ross Naylor (United Kingdom, Carotid Expert and  World Leader) and Professor Matt Thompson (California ,USA,one of the current world-leading endovascular surgeons) .

Dr Vann was former Head of Vascular Surgery, South and East Auckland Vascular Service, Middlemore Hospital, Auckland, New Zealand.
Currently he is a Visiting Specialist Vascular Surgeon in the following institutions:
 
Auckland Regional Vascular Unit - Auckland City Hospital
MercyAscot Group of Hospitals, Remuera /Epsom
Brightside Southern Cross Group, Epsom
Ormiston Hospital, Botany/Flat Bush
Apollo Medical, Albany

Dr Peter Vann is an Honorary Senior Lecturer Vascular Surgery, University of Auckland Medical School;
Examiner in Surgery, University of Auckland Medical School;
Director and Supervisor of Vascular Surgery Training, Royal Australasian College of Surgeons;
Convener of the FRACS Part 2 fellowship examination RACS;
Trustee, Medical Aid Abroad New Zealand;
Pioneer Vascular Surgeon to the Pacific Islands Samoa 2005;
Lead Medical Aid Co-ordinator Post Tsunami Sri Lanka 2004.

Staff

Dr Peter Vann has 4 PA's , including an Accounts Manager at his central office in Remuera.

Consultants

Referral Expectations

When you come to your appointment, your surgeon will ask questions about your illness and examine you to try to determine or confirm the diagnosis. This process may also require a number of tests (e.g. blood tests, x-rays, scans etc). Sometimes this can all be done during one visit, but for some conditions this will take several follow-up appointments. Occasionally some tests are arranged even before your appointment to try to speed up the process.
 
After your scan and investigations, you need to make an appointment to see your surgeon again. Once a diagnosis has been made, your surgeon will discuss treatment options with you. In some instances this will mean surgery or interventional radiology, while other cases can be managed with medication and advice. If surgery is advised, the steps involved in the surgical process and the likely outcome are usually discussed with you at this time.

Fees and Charges Description

Initial consultation charge $350

Follow Up Charge: $195

Hours

9:00 AM to 5:00 PM.

Mon – Fri 9:00 AM – 5:00 PM

Outside these hours ONLY by prior arrangement.

Clinics throughout Auckland and Greater Auckland Area.

Available for urgent GP consults/referrals - via my PA (09) 520 9543. Fax for referrals 0800 4 VASCULAR. After hours appointments also available by prior arrangement ONLY.

Operating sessions - regularly; weekly at Ascot, Mercy, Brightside (Southern Cross) and Ormiston Hospitals. Emergency operating sessions also available by prior arrangement ONLY. 

Common Conditions

Vascular Disorders

Vascular (blood vessel) disorders treated by vascular surgery include varicose veins, blockages and narrowings in the arteries or abnormal swellings of the arteries (aneurysm). The most common of these venous conditions facing the vascular surgeon is varicose veins. This occurs when veins in the legs and thighs become enlarged and twisted. This is often caused by the failure of the one-way valve system in the veins, in which case it can be treated surgically by removing the segments of veins containing the malfunctioning valves as well as those veins which are significantly dilated. Arterial problems can be due to blockages, narrowings or dilatations (swellings). Treatment for each problem, depends on the site of the artery and the underlying pathology. Patients medical condition will be taken into consideration when offering treatment options. New endovascular treatments are also available depending on the suitability of the artery, situation and pathology.

Vascular (blood vessel) disorders treated by vascular surgery include varicose veins, blockages and narrowings in the arteries or abnormal swellings of the arteries (aneurysm).

The most common of these venous conditions facing the vascular surgeon is varicose veins. This occurs when veins in the legs and thighs become enlarged and twisted. This is often caused by the failure of the one-way valve system in the veins, in which case it can be treated surgically by removing the segments of veins containing the malfunctioning valves as well as those veins which are significantly dilated.

Arterial problems can be due to blockages, narrowings or dilatations (swellings). Treatment for each problem, depends on the site of the artery and the underlying pathology. Patients medical condition will be taken into consideration when offering treatment options. New endovascular treatments are also available depending on the suitability of the artery, situation and pathology.

Aortic Aneurysm

This is the dilatation or ballooning of a section of the aorta which is the main artery coming out of the heart. An aneurysm usually occurs because of an underlying weakness in the wall of the aorta at that point. Very often you will not have any symptoms from the aneurysm and it may only be discovered through a chest x-ray or CT scan. If the aneurysm begins to get larger or leak, you may experience chest or back pain. If there is a risk of the aneurysm bursting, surgery will be required.

This is the dilatation or ballooning of a section of the aorta which is the main artery coming out of the heart. An aneurysm usually occurs because of an underlying weakness in the wall of the aorta at that point.
Very often you will not have any symptoms from the aneurysm and it may only be discovered through a chest x-ray or CT scan. If the aneurysm begins to get larger or leak, you may experience chest or back pain.
If there is a risk of the aneurysm bursting, surgery will be required.
Carotid Artery Disease

You have two carotid arteries, one on either side of your neck, that supply blood to your brain. Carotid artery disease occurs if these arteries become narrowed due to atherosclerosis (a build up of fat and cholesterol deposits on the inner walls of the vessels). If a clot forms in one of the carotid arteries and reduces or stops the flow of blood to part of your brain, it may cause a stroke. You have an increased risk of developing carotid artery disease if you: · have a family history of atherosclerosis · smoke · have high blood pressure (hypertension) · have diabetes · have coronary artery disease. Treatment may involve lifestyle changes e.g. stopping smoking, exercising more, dietary changes and/or medication. If there is severe narrowing of the arteries, treatment may involve surgery.

You have two carotid arteries, one on either side of your neck, that supply blood to your brain. Carotid artery disease occurs if these arteries become narrowed due to atherosclerosis (a build up of fat and cholesterol deposits on the inner walls of the vessels). If a clot forms in one of the carotid arteries and reduces or stops the flow of blood to part of your brain, it may cause a stroke.
You have an increased risk of developing carotid artery disease if you:
·        have a family history of atherosclerosis
·        smoke
·        have high blood pressure (hypertension)
·        have diabetes
·        have coronary artery disease.
Treatment may involve lifestyle changes e.g. stopping smoking, exercising more, dietary changes and/or medication. If there is severe narrowing of the arteries, treatment may involve surgery.
Peripheral Arterial Disease

Peripheral arterial disease refers to the narrowing of arteries outside the heart and brain, usually as the result of atherosclerosis or "hardening of the arteries" (a build up of fatty deposits on the inner wall of arteries). When the arteries become narrowed, the flow of blood to the target organs or tissues is reduced. The arteries commonly affected are those carrying blood to the kidneys, stomach, arms and legs. Peripheral arterial disease often appears first in your legs, with the most common symptom being dull, cramping leg pain that occurs when exercising but stops when you stand still. This is known as "intermittent claudication". Treatment for peripheral arterial disease may involve medication and/or surgery.

Peripheral arterial disease refers to the narrowing of arteries outside the heart and brain, usually as the result of atherosclerosis or "hardening of the arteries" (a build up of fatty deposits on the inner wall of arteries). When the arteries become narrowed, the flow of blood to the target organs or tissues is reduced.
The arteries commonly affected are those carrying blood to the kidneys, stomach, arms and legs. Peripheral arterial disease often appears first in your legs, with the most common symptom being dull, cramping leg pain that occurs when exercising but stops when you stand still. This is known as "intermittent claudication".
Treatment for peripheral arterial disease may involve medication and/or surgery.
Varicose Veins

These are bulging veins that lie just beneath the skin (superficial veins). They occur when the walls of a vein are weak or damaged or if the valves in the vein that normally stop the blood from flowing backwards are impaired, resulting in pooling of the blood and stretched veins. Besides being unattractive, varicose veins can be painful and cause inflammation or ulceration. The following different types of surgery are available if varicose veins require treatment: Sclerotherapy – a tiny needle is used to inject a chemical solution into the vein that causes the vein to collapse. This approach is recommended for small varicose veins or spider veins that typically appear on the upper legs. You will need to wear elastic bandages or stockings over the treated area for some time after surgery. Vein stripping – the varicose veins are cut out and the veins that branch off them are tied off. The cuts (incisions) made in the skin are closed with sutures or steristrips. You may need to wear elastic bandages or stockings over the treated area for some time after surgery. This procedure requires anaesthesia. Phlebectomy – small cuts (incisions) are made in the leg and the varicose veins are pulled out with a tiny hook-like instrument. The cuts are closed with tape rather than sutures and, once healed, are almost invisible. You may need to wear elastic bandages or stockings over the treated area for some time after surgery. This procedure requires anaesthesia.

These are bulging veins that lie just beneath the skin (superficial veins). They occur when the walls of a vein are weak or damaged or if the valves in the vein that normally stop the blood from flowing backwards are impaired, resulting in pooling of the blood and stretched veins. Besides being unattractive, varicose veins can be painful and cause inflammation or ulceration.
The following different types of surgery are available if varicose veins require treatment:

Sclerotherapy – a tiny needle is used to inject a chemical solution into the vein that causes the vein to collapse. This approach is recommended for small varicose veins or spider veins that typically appear on the upper legs. You will need to wear elastic bandages or stockings over the treated area for some time after surgery.

Vein stripping – the varicose veins are cut out and the veins that branch off them are tied off. The cuts (incisions) made in the skin are closed with sutures or steristrips. You may need to wear elastic bandages or stockings over the treated area for some time after surgery. This procedure requires anaesthesia.

Phlebectomy – small cuts (incisions) are made in the leg and the varicose veins are pulled out with a tiny hook-like instrument. The cuts are closed with tape rather than sutures and, once healed, are almost invisible. You may need to wear elastic bandages or stockings over the treated area for some time after surgery. This procedure requires anaesthesia.

Ulcers

Vascular ulcers are open wounds on the skin that do not heal or that keep coming back once they do heal. They occur because there is not enough blood being supplied to the skin to heal injuries that may be caused by minor trauma or pressure. Arterial or ischaemic ulcers are usually the result of atherosclerosis or "hardening of the arteries" (a build up of fatty deposits on the inner wall of arteries). When the arteries become narrowed, the flow of blood to the tissues is reduced. These ulcers are usually found on the toes and edge of the foot and are often very painful. Treatment for arterial ulcers may involve surgery. Venous or stasis ulcers occur when impaired blood flow in the veins causes pooling of blood in the legs. These ulcers are often associated with varicose veins. Venous ulcers are usually found on the lower leg between the knee and the ankle and the leg is often swollen and discoloured. Compression or pressure bandages are the main treatment for venous ulcers although surgery may be required in some patients.

Vascular ulcers are open wounds on the skin that do not heal or that keep coming back once they do heal. They occur because there is not enough blood being supplied to the skin to heal injuries that may be caused by minor trauma or pressure.
Arterial or ischaemic ulcers are usually the result of atherosclerosis or "hardening of the arteries" (a build up of fatty deposits on the inner wall of arteries). When the arteries become narrowed, the flow of blood to the tissues is reduced. These ulcers are usually found on the toes and edge of the foot and are often very painful. Treatment for arterial ulcers may involve surgery.
Venous or stasis ulcers occur when impaired blood flow in the veins causes pooling of blood in the legs. These ulcers are often associated with varicose veins. Venous ulcers are usually found on the lower leg between the knee and the ankle and the leg is often swollen and discoloured. Compression or pressure bandages are the main treatment for venous ulcers although surgery may be required in some patients.
Skin Disorders

Skin conditions dealt with by general surgery include lumps, tumours and other lesions of the skin and underlying tissues. These are often fairly simple conditions that can be dealt with by performing minor operations under local anaesthetic (the area of skin being treated is numbed). Often these procedures are performed as outpatient or day case procedures.

Skin conditions dealt with by general surgery include lumps, tumours and other lesions of the skin and underlying tissues. These are often fairly simple conditions that can be dealt with by performing minor operations under local anaesthetic (the area of skin being treated is numbed). Often these procedures are performed as outpatient or day case procedures.

Carotid Endarterectomy

Carotid surgery is usually done to prevent stroke. This constitutes a "cleaning" out of the main artery in your neck taking blood to the brain. This is done through a 10 - 15cm neck incision which is not a painful operation but a delicate one, as we deal with blood that goes to your brain. I usually use a temporary shunt whilst I work on your artery and then close this with a patch to prevent blockage or narrowing. Patients usually go home in 2 to 3 days. This is a routine operation in specialist hands with minimal complications.

Carotid surgery is usually done to prevent stroke. This constitutes a "cleaning" out of the main artery in your neck taking blood to the brain. This is done through a 10 - 15cm neck incision which is not a painful operation but a delicate one, as we deal with blood that goes to your brain. I usually use a temporary shunt whilst I work on your artery and then close this with a patch to prevent blockage or narrowing. Patients usually go home in 2 to 3 days. This is a routine operation in specialist hands with minimal complications.

Abdominal Aortic Disease Treatment - Endovascular or Open Surgery

The abdominal aorta is the main artery from the heart to come down to your abdomen. It can get diseased and cause either narrowing, blockage or the wall can get weakened and form an aneurysm which is a common problem in smokers, usually males in the 65 to 80 yr age group. If there is a blockage this could be bypassed with a graft or treated with a stent. If there is an aneurysm (ballooning of the wall), once it reaches a certain size it can burst (rupture) and the patient can die from this. Treatment is preferable before symptoms, either: Open Surgical repair with a graft sewn into the aorta to exclude the blood flow into the sac. This is via an incision in your abdomen and recovery usually takes 5 - 7 days OR Endovascular repair with a stent graft via a cut in the groin, the recovery is faster 2 - 3 days but not all aneurysms are suitable for this type of treatment. The shape and dimensions have to meet certain criteria to be suitable for a stent graft; your specialist will discuss this with you after first ordering a CT scan.

The abdominal aorta is the main artery from the heart to come down to your abdomen. It can get diseased and cause either narrowing, blockage or the wall can get weakened and form an aneurysm which is a common problem in smokers, usually males in the 65 to 80 yr age group. If there is a blockage this could be bypassed with a graft or treated with a stent. If there is an aneurysm (ballooning of the wall), once it reaches a certain size it can burst (rupture) and the patient can die from this. Treatment is preferable before symptoms, either:

  1. Open Surgical repair with a graft sewn into the aorta to exclude the blood flow into the sac. This is via an incision in your abdomen and recovery usually takes 5 - 7 days OR
  2. Endovascular repair with a stent graft via a cut in the groin, the recovery is faster 2 - 3 days but not all aneurysms are suitable for this type of treatment. The shape and dimensions have to meet certain criteria to be suitable for a stent graft; your specialist will discuss this with you after first ordering a CT scan.
Peripheral Vascular Disease Treatment with Bypass OR Endovascular Methods

This is usually done for severe limb pain, arterial ulcers, gangrene or necrosis. It is usually done in the legs but very rarely in the arms. The treatment options are either: Endovascular - balloons and or stents to open up the narrowed / blocked areas in the arteries OR Surgical bypass using your own vein as a "pipe" to carry blood from above the blockage to below it. The decision regarding which type of treatment, and how, will be discussed with you after appropriate scans to road map the arteries and in consultation with your specialist. Patients MUST stop smoking and their risk factors must be controlled to get an optimal (best) result which is durable (long lasting). Ideally patients are on an anti clotting substance like aspirin, anti cholesterol medication and have good control of their blood pressure prior to treatment for best results.

This is usually done for severe limb pain, arterial ulcers, gangrene or necrosis. It is usually done in the legs but very rarely in the arms. The treatment options are either:

  1. Endovascular - balloons and or stents to open up the narrowed / blocked areas in the arteries OR
  2. Surgical bypass using your own vein as a "pipe" to carry blood from above the blockage to below it.

The decision regarding which type of treatment, and how, will be discussed with you after appropriate scans to road map the arteries and in consultation with your specialist. Patients MUST stop smoking and their risk factors must be controlled to get an optimal (best) result which is durable (long lasting). Ideally patients are on an anti clotting substance like aspirin, anti cholesterol medication and have good control of their blood pressure prior to treatment for best results.

Vascular Access for Dialysis or Oncology

Access for dialysis is done by a small incision under anaesthesia, to create a fistula in the upper limbs by connecting a superficial vein to an artery, so that it can be used for dialysis. Access for chemotherapy is by placing a Portacath, under anaesthesia, in your neck vein using an ultrasound and a Port for chemotherapy under your skin on the chest wall for puncture for the drugs to be administered.

Access for dialysis is done by a small incision under anaesthesia, to create a fistula in the upper limbs by connecting a superficial vein to an artery, so that it can be used for dialysis.

Access for chemotherapy is by placing a Portacath, under anaesthesia, in your neck vein using an ultrasound and a Port for chemotherapy under your skin on the chest wall for puncture for the drugs to be administered.

Contact Details

9:00 AM to 5:00 PM.

Direct line (09) 520 9543 (PA) 


Any urgent referrals contact my PA      09 5209543

eReferrals via Healthlink and Medtech  EDI: VASCVANN

260 Botany Rd
Howick
Auckland

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Street Address

260 Botany Rd
Howick
Auckland

Postal Address

Dr Peter Vann
Auckland Vascular Surgery
PO Box 12 8347
Remuera
Auckland 1541

Ascot Hospital, 90 Green Lane East, Remuera, Auckland

Central Auckland

9:00 AM to 5:00 PM.

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eastMED, 188 St Heliers Bay Road, St Heliers, Auckland

Central Auckland

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This page was last updated at 9:51AM on July 8, 2024. This information is reviewed and edited by Auckland Vascular & Varicose Vein Clinic - Dr Peter Vann.