Vascular Surgery


Phone01 414 4017 
Fax01 414 2212
Postal AddressDept of General & Vascular Surgery, Tallaght Hospital, Tallaght, Dublin 24. 

Description of Department/Service

Vascular Surgery Unit

Our Vascular Unit in Tallaght Hospital provides in-patient and out-patient vascular surgery services to the population of South West Dublin, West Wicklow and all of Kildare - a combined population of more than 500,000.

Outpatient and inpatient services are provided in Tallaght Hospital while an outreach service is also provided in Naas Vista Clinic.

The unit is staffed by  Consultant Surgeons - Mr Sean Tierney (appointed 2000) and Ms Bridget Egan (2007). This Consultant team is supported by two senior trainees, one basic surgical trainee and two pre-registration house officers. There is a fully equipped vascular laboratory with three full time technicians and administrative support.

Non-operative treatment, open surgery, and endovascular surgery is offered for the full range of vascular disorders including aortic disease, carotid disease, peripheral arterial disease, venous and lymphatic disorders. Treatment is provided in a collaborative fashion with medical and anaesthetic specialists.

The first endovascular repair of an abdominal aortic aneurysm was performed in the Adelaide Hospital in 1998 and more than half of all AAA repairs are now performed endovascularly (EVAR). EVAR repair is currently being extended to emergency repairs and we hope to offer a 24/7 EVAR service for all suitable patients in the near future.

Peripheral angioplasty in our unit is performed by vascular surgeons and there is sufficient volume to provide the opportunity for endovascular accreditation of vascular trainees during a years training.  As there is a large diabetic population locally, we also perform a significant number of open lower limb reconstructions to the crural or pedal vessels each per year. A proposed new combined vascular and endocrinology diabetic foot clinic will begin shortly.

There is a fully staffed stroke rehabilitation unit in Tallaght Hospital with a growing demand for carotid surgery. In addition, patients with carotid disease are assessed in a multidisciplinary (vascular, stroke medicine, neurology) rapid access TIA clinic and discussed at a multidisciplinary meeting once a week. A carotid stent/angioplasty programme is being developed with this procedure being offered initally to those at high risk for open surgery.

There is a large dialysis unit in the hospital and a high demand for primary and revision vascular access work. 

The management of superficial and deep venous problems has been an important source of clinical research in our unit over the past 10 years.

This is also an award winning teaching unit that has developed innovative teaching programmes (including e-learning) for undergraduate medical students, postgraduate surgical trainees, and vascular laboratory students.

Referrals

New patients can only be referred by their General Practitioner, another consultant or other healthcare provider who is treating them. Your GP or Consultant may submit the referral directly or may give you a letter to arrange your own appointment. 

Clinical Information

Protocols

This section includes the protocols we use in our unit for the pre-, peri-, and post-operative management of patients with a variety of conditions. These are a guide to practice and are not a substitute for the appropriate use of clinical expertise

Publications

Beddy, P., Ridgway, P., Beddy, D., Clarke, E., Traynor, O. & Tierney, S. (2008), "Defining useful surrogates for user participation in online medical learning.". Adv Health Sci Educ Theory Pract .

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Broe, D., Ridgway, P.F., Johnson, S., Tierney, S. & Conlon, K.C. (2006), "Construct validation of a novel hybrid surgical simulator.". Surg Endosc . Volume 20(6), pp. 900-904.

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Cox, M., Madhavan, P. & Feeley, T.M. (1998), "Primary repair of ruptured aortitis.". Eur J Vasc Endovasc Surg . Volume 15(5), pp. 454-455.

Crerand, S., Feeley, T.M., Waldron, R.P., Corrigan, T., Hederman, W., O'Connell, F.X. & Heffernan, S.J. (1991), "Colorectal carcinoma over 30 years at one hospital: no evidence for a shift to the right.". Int J Colorectal Dis . Volume 6(4), pp. 184-187.

Davies, M.G., Feeley, T.M., Moore, D.J. & Shanik, G.D. (1990), "Home parenteral nutrition using a totally implanted subcutaneous venous access device.". Br J Clin Pract . Volume 44(12), pp. 750. 

Davies, M.G., Feeley, T.M., O'Malley, M.K., Colgan, M.P., Moore, D.J. & Shanik, G.D. (1991), "Infrainguinal polytetrafluoroethylene grafts: saved limbs or wasted effort? A report on ten years' experience.". Ann Vasc Surg . Volume 5(6), pp. 519-524.

Dillon, M.F., Carr, C.J., Feeley, T.M.F. & Tierney, S. (2005), "Impact of the informed consent process on patients' understanding of varicose veins and their treatment.". Ir J Med Sci . Volume 174(3), pp. 23-27.

Donnelly, M., Tierney, S. & Feeley, T.M. (2005), "Anatomical variation at the saphenofemoral junction.". Br J Surg . Volume 92(3), pp. 322-325.

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Egan, B., Donnelly, M., Bresnihan, M., Tierney, S. & Feeley, M. (2006), "Neovascularization: an "innocent bystander" in recurrent varicose veins.". J Vasc Surg . Volume 44(6), pp. 1279-84; discussion 1284.

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Egan, B., O'Byrne, J.M., O'Farrell, D., O'Donnell, A., Wood, A.E., Neligan, M.C. & O'Brien, T.M. (1996),"Orthopaedic complications following cardiac transplantation.". Ir Med J . Volume 89(1), pp. 26-27.

Egan, B.M., Abdih, H., Kelly, C.J., Condron, C. & Bouchier-Hayes, D.J. (2001), "Effect of intravenous taurine on endotoxin-induced acute lung injury in sheep.". Eur J Surg . Volume 167(8), pp. 575-580.

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Egan, B.M., Bouchier-Hayes, D.J., Condron, C., Kelly, C.J. & Abdih, H. (2002), "Taurolidine attenuates the hemodynamic and respiratory changes associated with endotoxemia.". Shock . Volume 17(4), pp. 308-311.

Egan, B.M., Chen, G., Kelly, C.J. & Bouchier-Hayes, D.J. (2001), "Taurine attenuates LPS-induced rolling and adhesion in rat microcirculation.". J Surg Res . Volume 95(2), pp. 85-91.

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Eguare, E., Tierney, S., Barry, M.C. & Grace, P.A. (2000), "Management of head injury in a regional hospital.". Ir J Med Sci . Volume 169(2), pp. 103-106.

Eguare, E., Tierney, S., Maher, R., Creamer, M., Grace, P., Cronin, C.J. & Burke, P. (2006), "Demands for vascular access in a renal dialysis unit: implications for a regional vascular unit.". Ir J Med Sci . Volume 175(1), pp. 24-28.

Feeley, T.M., Clanachan, A.S. & Scott, G.W. (1987), "Contractility of human gallbladder muscle in vitro.". Aliment Pharmacol Ther . Volume 1(6), pp. 607-616.

Feeley, T.M., Clanachan, A.S. & Scott, G.W. (1984), "The effects of vasoactive intestinal polypeptide on the motility of human and guinea pig gallbladder.". Can J Physiol Pharmacol . Volume 62(4), pp. 356-359.

Feeley, T.M., Leen, E.J., Colgan, M.P., Moore, D.J., Hourihane, D.O. & Shanik, G.D. (1991), "Histologic characteristics of carotid artery plaque.". J Vasc Surg . Volume 13(5), pp. 719-724. 

Feeley, T.M., Longe, L.G. & Ellis, W. (1984), "Results of surgery for prolapsed intervertebral disc.". Ir Med J . Volume 77(3), pp. 72-74.

Feeley, T.M., McFarlane, D.E. & Devlin, H.B. (1982), "Acute appendicitis: are any investigations cost effective?". Ir Med J . Volume 75(12), pp. 475-476.

Feeley, T.M. & O'Higgins, N. (1983), "An atypical case of abdominal actinomycosis.". Ir Med J . Volume 76(9), pp. 387.

[BibTeX]

Feeley, T.M., Peel, A.L. & Devlin, H.B. (1982), "Mastectomy and its consequences.". Br Med J (Clin Res Ed) . Volume 284(6324), pp. 1246.

Feeley, T.M. & Rosenberg, I.L. (1984), "Malignant change in fistula-in-ano.". Ir Med J . Volume 77(10), pp. 326. 

Fenlon, H.M., Phelan, N., Tierney, S., Gorey, T. & Ennis, J.T. (1998), "Tc-99m tetrofosmin scintigraphy as an adjunct to plain-film mammography in palpable breast lesions.". Clin Radiol . Volume 53(1), pp. 17-24. 

Fenlon, H.M., Phelan, N.C., O'Sullivan, P., Tierney, S., Gorey, T. & Ennis, J.T. (1997), "Benign versus malignant breast disease: comparison of contrast-enhanced MR imaging and Tc-99m tetrofosmin scintimammography.". Radiology . Volume 205(1), pp. 214-220.

Fitzgerald, E., Feeley, T.M. & Tierney, S. (2004), "Current treatments for axillary hyperhidrosis.". Surgeon . Volume 2(6), pp. 311-4, 360.

Flynn, R., Geraghty, J.G., Keogh, B. & Feeley, T.M. (1991), "Rare presentation of gastric leiomyosarcoma.". Postgrad Med J . Volume 67(788), pp. 589-590. 

Geoghegan, T., Persaud, T., O'Grady, H., Tierney, S. & Torreggiani, W.C. (2005), "Aorto-caval fistula.". Hosp Med . Volume 66(7), pp. 425.

Gill, K.P., Feeley, T.M. & Keane, F.B. (1989), "Toxic megacolon and perforation caused by Salmonella.". Br J Surg . Volume 76(8), pp. 796.

Gorey, T.F., O'riordain, M.G., Tierney, S., Buckley, D. & Fitzpatrick, J.M. (1996), "Laparoscopic-assisted rectopexy using a novel hand-access port.". J Laparoendosc Surg . Volume 6(5), pp. 325-328.

Gorey, T.F., Tierney, S., O'Riordain, M., Buckley, D., Gibbons, N. & Fitzpatrick, J.M. (1996), "Case report: combined hand access with laparoscopic pneumoperitoneum in intraperitoneal adhesiolysis.". Ir J Med Sci . Volume 165(4), pp. 297-298.

Havránek, E.G., Tierney, S., Man, W.K., Scott-Coombes, D.M. & Thompson, J.N. (1999), "The role of fibrinolytic system proteins in cholesterol gallstone formation.". Scand J Gastroenterol . Volume 34(5), pp. 516-519.

Healy, C.F., Doyle, M., Egan, B., Hendrick, B., O'Malley, M.K. & O'Donohoe, M.K. (2007), "Transfusion requirements and outcomes in patients undergoing abdominal aortic surgery using intra-operative cell salvage.". Ir J Med Sci . Volume 176(1), pp. 33-36.

Issa, M.M., Feeley, T.M., Beesley, W.H., Daly, P.A. & Cullinane, C.J. (1987), "Haemangiosarcoma of the breast.". Ir J Med Sci . Volume 156(2), pp. 65.

Kalbassi, M.R., Tierney, S., Grace, P.A. & Burke, P.E. (2000), "Regional vascular surgical units: a practical means of providing specialist services.". Ir J Med Sci . Volume 169(2), pp. 107-109.

Kiely, P.D., Tierney, S., Barry, M., Delaney, P.V., Drumm, J. & Grace, P.A. (2000), "Infantile hypertrophic pyloric stenosis in a regional centre.". Ir J Med Sci . Volume 169(2), pp. 100-102. 

Kingston, R., Barry, M., Tierney, S., Drumm, J. & Grace, P. (2001), "Treatment of surgical patients is evidence-based.". Eur J Surg . Volume 167(5), pp. 324-330.

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Leahy, A.L., McCollum, P.T., Feeley, T.M., Sugrue, M., Grouden, M.C., O'Connell, D.J., Moore, D.J. & Shanik, G.D. (1988), "Duplex ultrasonography and selection of patients for carotid endarterectomy: plaque morphology or luminal narrowing?". J Vasc Surg . Volume 8(5), pp. 558-562.

Leen, E.J., Feeley, T.M., Colgan, M.P., O'Malley, M.K., Moore, D.J., Hourihane, D.O. & Shanik, G.D. (1990), ""Haemorrhagic" carotid plaque does not contain haemorrhage.". Eur J Vasc Surg . Volume 4(2), pp. 123-128.

Lennon, F., Feeley, T.M., Clanachan, A.S. & Scott, G.W. (1984), "Effects of histamine receptor stimulation on diseased gallbladder and cystic duct.". Gastroenterology . Volume 87(2), pp. 257-262. 

Lipsett, P.A., Tierney, S., Gordon, T.A. & Perler, B.A. (1994), "Carotid endarterectomy--is intensive care unit care necessary?". J Vasc Surg . Volume 20(3), pp. 403-9; discussion 409-10. 

Madhavan, P., Boyle, T., Coyle, J., Cox, M., McEniff, N., Molloy, M. & Feeley, T.M. (1998), "Cystic adventitial disease.". Eur J Vasc Endovasc Surg . Volume 15(5), pp. 456-458.

Maher, M., Caldwell, M.P., Waldron, R., Murchan, P., Beesley, W., Feeley, T.M., Tanner, W.A. & Keane, F.B. (1996), "Staged resection or primary anastomosis for obstructing lesions to the left colon.". Ir Med J . Volume 89(4), pp. 138-139. 

McCormick, P.H., Chen, G., Tierney, S., Kelly, C.J. & Bouchier-Hayes, D.J. (2003), "Clinically applicable thermal preconditioning attenuates leukocyte-endothelial interactions.". J Am Coll Surg . Volume 197(1), pp. 71-78.

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McCormick, P.H., Tanner, W.A., Keane, F.B.V. & Tierney, S. (2003), "Minimally invasive techniques in common surgical procedures: implications for training.". Ir J Med Sci . Volume 172(1), pp. 27-29. 

Murchan, P., Sugrue, M.E., O'Malley, M.K., Feeley, T.M., Shanik, D.G. & Moore, D.J. (1990), "A new technique for bilateral iliac vein and inferior vena cava reconstruction using reinforced polytetrafluoroethylene.". Ann Vasc Surg . Volume 4(3), pp. 302-304. 

Murphy, J.O., Sweeney, K.J., O'Mahony, J.C., Johnston, S.M., Conlon, K., Keane, F.B.V. & Tierney, S. (2003), "Surgical informatics on the Internet: any improvement?". Surgeon . Volume 1(3), pp. 177-179. 

Murphy, S.M., Donnelly, M., Fitzgerald, T., Tanner, W.A., Keane, F.B.V. & Tierney, S. (2004), "Patients' recall of clinical information following laparoscopy for acute abdominal pain.". Br J Surg . Volume 91(4), pp. 485-488.

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Murphy, S.M. & Tierney, S. (2002), "A normal appendix found during diagnostic laparoscopy should not be removed (Br J Surg 2001;88:251-4).". Br J Surg . Volume 89(5), pp. 624; author reply 625. 

O'Donohoe, M.K., Murchan, P.M., Marks, P., Feely, J. & Feeley, T.M. (1993), "Endothelium derived relaxing factor is absent in experimental in situ vein grafts.". Eur J Vasc Surg . Volume 7(2), pp. 144-150. 

O'Riordan, J.M., Fitzgerald, E., Gowing, C., O'Grady, H., Feeley, T.M. & Tierney, S. (2006), "Topical local anaesthetic (tetracaine) reduces pain from botulinum toxin injections for axillary hyperhidrosis.". Br J Surg . Volume 93(6), pp. 713-714.

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Quinlan, M.R., Egan, B., Feeley, T.M. & Tierney, S. (2008), "Changing trends in surgical treatment of carotid disease in Ireland (1996-2003).". Ir J Med Sci . Volume 177(3), pp. 193-196.

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Roche-Nagle, G., Curran, J., Bouchier-Hayes, D.J. & Tierney, S. (2007), "Risk-based evaluation of thromboprophylaxis among surgical inpatients: are low risk patients treated unnecessarily?". Ir J Med Sci . Volume 176(3), pp. 169-173.

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Sugrue, M.E., Carolan, J., Leen, E.J., Feeley, T.M., Moore, D.J. & Shanik, G.D. (1990), "The use of infrared laser therapy in the treatment of venous ulceration.". Ann Vasc Surg . Volume 4(2), pp. 179-181. 

Tierney, S., Aslam, M., Rennie, K. & Grace, P. (1996), "Infrared optoelectronic volumetry, the ideal way to measure limb volume.". Eur J Vasc Endovasc Surg . Volume 12(4), pp. 412-417.

Tierney, S., Burke, P., Fitzgerald, P., O'Sullivan, T., Grace, P. & Bouchier-Hayes, D. (1993), "Ankle fracture is associated with prolonged venous dysfunction.". Br J Surg . Volume 80(1), pp. 36-38. 

Tierney, S., Fennessy, F. & Hayes, D.B. (2000), "ABC of arterial and vascular disease. Secondary prevention of peripheral vascular disease.". BMJ . Volume 320(7244), pp. 1262-1265. 

Tierney, S., Lillemoe, K.D. & Pitt, H.A. (1995), "The current management of common duct stones.". Adv Surg . Volume 28, pp. 271-299.

Tierney, S., Nakeeb, A., Wong, O., Lipsett, P.A., Sostre, S., Pitt, H.A. & Lillemoe, K.D. (1999),"Progesterone alters biliary flow dynamics.". Ann Surg . Volume 229(2), pp. 205-209. 

Tierney, S., Pitt, H.A. & Lillemoe, K.D. (1993), "Physiology and pathophysiology of gallbladder motility.". Surg Clin North Am . Volume 73(6), pp. 1267-1290. 

Tierney, S., Qian, Z., Burrow, C., Lipsett, P.A., Pitt, H.A. & Lillemoe, K.D. (1994), "Estrogen inhibits sphincter of Oddi motility.". J Surg Res . Volume 57(1), pp. 69-73.

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Tierney, S., Qian, Z., Lipsett, P.A., Pitt, H.A. & Lillemoe, K.D. (1998), "Ethanol inhibits sphincter of Oddi motility.". J Gastrointest Surg . Volume 2(4), pp. 356-362. 

Tierney, S., Qian, Z., Yung, B., Lipsett, P.A., Pitt, H.A., Sostre, S. & Lillemoe, K.D. (1995), "Gender influences sphincter of Oddi response to cholecystokinin in the prairie dog.". Am J Physiol . Volume 269(4 Pt 1), pp. G476-G480. 

Tierney, S., Russell, J.D., Walsh, M. & Folan-Curran, J. (1993), "Innervation of the rat tympanic membrane from the superior cervical and glossopharyngeal ganglia.". J Anat . Volume 182 ( Pt 3), pp. 355-360. 

Watson, D.P., Murphy, P.D., Feeley, T.M. & Given, F. (1986), "Adenocarcinoma of the duodenum and iron deficiency anaemia.". Ir Med J . Volume 79(5), pp. 134.