Dr Arvind Deshpande
Vascular and Endovascular Surgeon
NEWCASTLE &
LAKE MACQUARIE
Areas of Expertise
All aspects of arterial, venous and endovascular surgery — including complex and uncommon conditions rarely offered elsewhere in the region. Open any card for symptoms and treatment options, or visit our information sheets for detailed guides to common operations.
Carotid and Vertebral Artery Intervention
Vast Experience of over 1000 carotid and vertebral artery interventions including open surgery and stenting with excellent outcomes. Team approach with Stroke Team and Neurologists at John Hunter. Well experienced in complex vertebral artery bypasses and carotid surgery at the base of skull. Well versed with carotid stenting and now being trained for TCAR ( Trans-carotid stenting)
Endovenous Laser for varicose veins
Over a decade of experience with high frequency laser for effective and durable treatment of varicose veins. Highly skilled team of vascular sonographers to make this a safe and precise procedure. Sclerotherapy under ultrasound guidance. High Frequency Laser is higly effective for superficial varicose veins and treating perforating veins in a minimally invasive manner. One stop treatment rather than multiple visits! Use of private insurance for most patients with a small gap as a result.
Thoracic Outlet Syndrome
Venous, Arterial and Neurogenic and Cervical Rib
Arvind offers thrombolysis and trans-axillary decompression for patients with venous congestion and effort related upper limb venous thrombosis Good team work with physiotherapists and pain specialists in patients with Neurogenic Thoracic Syndrome. Surgical Decompression offered in selected group who have not responded to physiotherapy and have debilitating symptoms. Offer prompt arterial reconstruction and operative decompression in arterial thoracic outlet syndrome. Excellent outcomes in all three types!
Deep and Hybrid Superficial Venous Arterialisation
Complex Salvage Procedure offered in reasonably fit patients with critical limb ischemia and severe small vessel disease with no options left other than amputation of the affected leg. Arvind is well versed with these procedures and has provided good limb salvage outcomes. Amputations avoided in all of these patients.
Abdominal Aortic Aneurysms
Well experienced in Abdominal Aortic Aneurysm management utilising Endoluminal Aortic Stenting as well as Open Surgical Approach. Each patient will have a customised solution based on overall health, size of aneurysm and its relation to the arteries to the kidneys and small intestine. Highly experienced in Cook-HLB, Gore Excluder and Medtronic Endografts Threshold for repair is 5 to 5.5 cms diameter and depends on the risk profile.
Complex Abdominal Aortic and Thoraco-Abdominal Aneurysms
Performs Fenestrated Aortic Endografts, Chimney Endografts(CHEVAR), Branched Endograft (TAMBE and T branch) and Iliac Branch device placement. Very experienced in these procedures. These aneurysms are close to or above the level of arteries to the kidneys and can extend above the diaphragm into the chest.
Pelvic Congestion Syndrome
15 to 20% of female patients 18 to 60 years of age are affected with varying degree of low pelvic and back pain, irregular heavy menses, labial varicose veins, atypical large veins in the perineum and legs and sometimes severe post-Coital pain due to large varicose and refluxing veins in the pelvis. Careful investigations to rule out other causes for the above symptoms and then embolisation of these veins with coils and glue provides excellent and durable improvement in quality of life. Small procedure with very big gains!
Blocked or Narrowed Aorta and/or Iliac Arteries
These patients present with cramping in buttocks thighs and calves on walking and loss of erectile function. Arvind is very experienced in open aorto-bi-femoral bypass as well as endovascular treatment with covered stents (CERAB procedure). Treatment depends on the type of blockage and the overall health and age. Minimally invasive approach with stents is the preferred approach with open surgery reserved for more complex and challenging cases.
Narrow or Blocked Arteries in Thighs and Calves
Cramping and burning in calves and/ or feet on walking. Narrowed or blocked arteries in thighs and calves due to smoking, diabetes and genetic predisposition can cause severe disability and impact on lifestyle and occupation. Treatment ranges from conservative management to open bypass or minimally invasive endovascular procedures. There has been an explosion of endovascular options. Plain or drug coated balloon angioplasty, coring of plaque by percutaneous atherectomy or placing self-expanding stents have become standard options with an open bypass reserved when endovascular options fail or are not possible. Age, overall health, risk profile and site and size of narrowing or blockage is taken into consideration.
Arteriovenous Fistula and Peritoneal Dialysis Access
Arteriovenous fistula and graft creation for hemo-dialysis along with use of latest endo-vascular techniques for maintaining patency. Well experienced in placement of peritoneal dialysis catheters using a laparascopic approach. Works in close association with Nephrologists and Dialysis access nurses.
Inflammation of Arteries- Vasculitis
Treatment of aftermath of Large, Medium and Small Vessel Vasculitis. Mostly endovascular and sometimes a hybrid approach is used. Patients present with a myriad of complaints including Stroke, Aneurysms, Loss of Pulses, Gangrene or loss of blood supply to critical abdominal organs such as kidneys, Liver or small intestine.
Thoracic Aneurysms, Aortic Arch Aneurysms and Dissections
Aneurysms in the chest with a diameter of 6 cms and above are considered dangerous and repaired with a stent graft through the groin. A split ( dissection) in the wall of the artery in the chest is highly dangerous and unpredictable and can rupture into the chest or extend down in to the abdomen cutting off blood supply to the legs or vital organs in the abdomen. Extension towards the heart can cause instant death by rupture into the covering envelope (pericardium) of the the heart. Arvind is well experienced in this highly specialised field uses endo-grafts and hybrid procedures for excellent outcomes.
Popliteal Artery Aneurysms
These aneurysms generally require treatment at a threshold diameter of 2 cms. Treatment is with stents or a bypass. These patients require an individual approach based on age, overall health and runoff arteries in the affected leg. Arvind is equally adept with both approaches.
Femoral Artery Aneurysms
Aneurysms in the groin 3 cms and larger are treated with an open approach using a polyester tube graft as replacement.
Treatment of Chronic Ulcers
Common presentation in the elderly population with a combination venous and arterial insufficiency in varying degrees. Careful history and investigations for an individualised solution. Patients may need anything from specialised compression dressings, Vacuum dressings to varicose vein surgery or angioplasty of a blocked artery. Vascular ultrasound, Isotope scans, toe pressure studies , MRI and CT angiograms for precise diagnosis and optimal treatment.
Angioplasty Of Renal Artery
Young patients with Fibromuscular Dysplasia of the arteries to the kidneys require angioplasty with intravascular ultrasound guidance. This is to prevent the kidneys from shrinking. In the older age group angioplasty and stenting of narrowing at the origin of these arteries is reserved for improving control of difficult to treat hypertension, delay or prevent total kidney failure and dialysis or prevent fluid accumulation in the lungs in patients with co-existing ischaemic heart disease. These complex decisions require vital input from a nephrologist.
Aneurysms of Arteries to Spleen, Kidneys, Intestines, Liver or Pancreas
These are highly dangerous and unpredictable in nature particularly splenic artery aneurysms in young female patients. Treatment is exclusively endovascular and sometimes combined with a hybrid open surgical bypass to the target vessel coupled with occlusion of the aneurysm with coils or glue. In some cases stent assisted coiling or flow diverting stents are used.
Arterio-Venous Malformations
Arvind uses a variety of diagnostic methods including CT scans, MRI and Vascular Ultrasound along with Diagnostic angiography to treat these malformations with an endovascular approach. Various types of coils and specialised glue are used to obtain a good result.
Popliteal Entrapment Syndrome, Chronic Recurrent Excercise Induced Compartment Syndrome and Other Uncommon Conditions
Experienced in treating uncommon debilitating conditions in young athletes]. He has a close relationship with sports physicians and has therefore provided effective treatment for popliteal entrapment syndrome, chronic recurrent exercise induced compartment syndrome (CRECS) as well as rarer conditions such as external iliac endofibrosis seen in hardcore and professional cyclists. He has treated patients with cystic adventitial disease of popliteal artery and even patients with adductor compression syndrome.
Deep venous Thrombosis and May Thurner Syndrome, NonThrombotic Intravascular Lesion (NIVL)
Arvind has a well rounded venous practice. He treats patients with Deep venous thrombosis of the Inferior vena cava and iliac veins in appropriate patients with latest interventions including the Inari basket, Angiojet Thrombectomy and routine thrombolysis. He uses hybrid theatre facilities and Intravascular ultrasound for endovascular management of conditions such as May Thurner Syndrome and Non thrombotic intravascular lesions NIVL which cause obstruction and DVT in young patients with devastating long term effects. He has performed successful stent assisted reconstruction of obstructed Inferior and Superior vena cava as well as the Iliac veins in suitable patients.
Geniculate Artery Embolisation for Osteoarthritis of the Knee and pain post TKR
Arvind has provided excellent results with this unique and precise technique for patients with advanced Osteoarthritis of the knee that are unfit for joint replacement or patient who have undergone a know replacement and have a stiff swollen and painful knee in spite of successful surgery. The technique involves pruning small vessels around the knee with a specific glue or emboli particles to reduce the inflammation and pain. This is now a well established technique. He accepts referrals from pain specialists, physicians and orthopaedic surgeons for these patients.
Carotid Body Tumours and Paraganglioma Treatment
Arvind has considerable experience treating these challenging tumours which can be found not only in the neck but also elsewhere in the body. Careful investigation, including specialised scans and the involvement of multiple specialists including Endocrine, ENT and Faciomaxillary surgeons provides an excellent outcome. Arvind has performed several intricate excisions at the base of the skull, including bypass grafts following excision of large tumours.