Modern vascular surgery

From big cuts to keyholes; the shift in vascular surgery that changed everything

Vascular surgery evolution

Big breakthroughs happened right here

Vascular surgery has come a long way since I started training. When I first began, it was all about open surgery. Big cuts, long operations, longer hospital stays, and a lot more risk for the patient. These procedures are still important and absolutely still used when needed, but they’re no longer the only way.

These days, we’re doing more from the inside of the blood vessel; through tiny incisions, often just in the groin. It’s called endovascular surgery, and it’s completely changed how we treat vascular conditions. We’re not talking small tweaks either, it’s been a revolution in how we operate and how patients recover.

“We went from large incisions and ICU stays to patients walking home the next day. That’s how much of a difference this shift has made.”

People are often surprised to hear this, but Perth has been right at the forefront of endovascular innovation. In fact, the first commercially available endovascular graft in the world was made right here at Royal Perth Hospital by a surgeon named Dr Michael Lawrence-Brown.

So in a way, Perth has made a much bigger impact in vascular surgery than most people would expect. I feel very lucky to be part of that tradition.

Endovascular surgery explained

The patient benefits are huge

Let’s say you’ve got a blocked or damaged artery. In the past, we would have needed a big operation to fix it. Now, we can thread a wire through a small opening; usually in the groin, and treat the problem from the inside using tools like stents, balloons, or even little drills called atherectomies that clear out calcium.

We use real-time imaging (a C-arm) in high-tech operating rooms called hybrid theatres. These rooms are a mix between a standard theatre and an advanced radiology suite. In the past, something like an aortic aneurysm repair might have meant days in ICU, a week in hospital, and sometimes a stay in a nursing home, especially for older patients. Now, with endovascular repair, we often send patients home the next day, walking and smiling. It’s quicker, safer, and recovery is just miles better.

Endovascular surgery isn’t just for aneurysms. It’s also used for blocked arteries, poor circulation in the legs, and even acute clots. Procedures like angioplasty and stenting are now common. And they often only take about 45 minutes to an hour:you can be home the same day

“These days, we can fix serious artery problems through a tiny incision, often in under an hour. Patients walk out the next day feeling like themselves again; it’s a complete game-changer.”

Diabetes and vascular surgery

We’re seeing fewer smokers but more diabetes

When I first started, smoking was the biggest risk factor for vascular disease. That’s changing. Fewer people are smoking now, which is great. But diabetes has taken its place as one of the main challenges we face, particularly when it comes to foot problems and ulcers.

These diabetic foot issues often stem from poor circulation, and they’re tricky. They need a team approach, I work closely with endocrinologists, podiatrists, infectious disease specialists, and wound care nurses. Whether it’s re-opening a blocked artery or planning reconstruction, it’s a real team effort.

“Diabetes is the new smoking when it comes to vascular disease. It’s affecting younger people and more city patients than you might expect.”

Technology in this field keeps moving. Our tools are getting better, our imaging sharper, and we’re always learning how to treat patients more safely and effectively. The durability of stents is improving too; even younger patients are now seeing long-term results.

While I still perform traditional open surgeries when needed, the shift towards minimally invasive procedures is a win for everyone. Faster recovery, fewer complications, and better outcomes. It’s why I do what I do.

“It’s a great time to be a vascular surgeon. The tools we have now can truly change people’s lives; and I see that happen every week.”

Health insurance for varicose veins

Contact Dr Altaf

If you have queries or are ready to make an appointment with Dr Nishath Altaf, please give us a call or request an appointment. Dr Altaf consults in Nedlands, Carine and Midland. He is best known in Perth for varicose vein treatment. Get in touch today.