Vascular referrals and second opinions
This page is written for colleagues in general medicine, diabetology, nephrology, orthopaedics, dermatology and gynaecology who see vascular presentations before we do. It sets out which cases benefit from early vascular input, what information makes the first consultation productive, and how urgent limb-threat referrals are handled.
MBBS — Topiwala National Medical College, Mumbai, MS (General Surgery), DNB Peripheral Vascular Surgery — Gold Medalist (awarded by the Hon'ble Ex Vice President of India), Fellowship in Endovascular Surgery · Vascular & Endovascular Surgeon · 21+ years of dedicated vascular and endovascular surgical experience
Full profile and training history on the doctor profile page.
When to refer
Foot or toe pain at rest, a non-healing ulcer, or gangrene needs arterial assessment without delay. These are limb-threat presentations where time to revascularisation changes the outcome.
Any diabetic foot ulcer with impalpable pedal pulses, or one that has not shown progress on standard wound care in two weeks, should be assessed for arterial inflow before further debridement planning.
Cramping calf pain reproducibly brought on by walking a fixed distance, particularly when it restricts work or is progressing, warrants arterial duplex and risk-factor review.
Extensive iliofemoral DVT, marked limb swelling, or recurrent DVT in a young patient may need imaging for an underlying iliac vein compression rather than anticoagulation alone.
Veins returning soon after stripping or ablation usually indicate an untreated source. In women, pelvic vein reflux is a recognised contributor and is assessed directly.
Where pain worsens through the day and with standing and imaging has been unremarkable, pelvic venous reflux is worth excluding. See the pelvic congestion pathway for the assessment used.
Vein mapping before first access, failing fistulas, and access-related steal or aneurysmal change are all managed jointly with nephrology.
An abdominal or thoracic aneurysm picked up on imaging needs size-based surveillance and a planned discussion about endovascular versus open repair thresholds.
What to send with the referral
- A brief clinical summary: symptom duration, walking distance if relevant, wound history, and comorbidities.
- Pedal pulse findings and ABI if available.
- Existing imaging — duplex, CT or MR angiography — as files or images rather than reports alone where possible.
- Current medication list, particularly antiplatelets, anticoagulants and antidiabetic agents.
- Renal function, HbA1c and haemoglobin where recently checked.
Pathways colleagues use most
Use the contact page for clinic timings, hospital address and phone numbers at Renova Century Hospital, Banjara Hills. For a suspected threatened limb, please call rather than email so the case can be seen the same day.