Utilising all available resources to prevent limb loss.
The Centre for Advanced Limb Preservation is dedicated to providing expert, patient-centred care for individuals suffering from critical limb ischemia and lower limb arterial occlusive disease.
Led by experienced vascular surgeons, we offer advanced revascularisation techniques and a multidisciplinary approach designed to prevent amputation and improve quality of life for patients facing serious limb threats.
Advanced revascularisation
Open surgical and endovascular interventions to restore blood flow and preserve limbs.
Deep Venous Arterialisation (DVA)
An innovative hybrid technique for patients with “No Option” or “Poor Option” CLTI.
Multidisciplinary care
Vascular, orthopaedic, endocrine, infectious disease, podiatry and hyperbaric specialists working together.
Amputation is a life-altering event with significant morbidity. We strongly believe that most cases can be successfully managed with the right expertise and care.
A referral hub for complex limb salvage
The Centre for Advanced Limb Preservation was founded with a deep commitment to saving limbs affected by CLTI and complex arterial disease.
Amputation is a life-altering event with significant morbidity, and we strongly believe that most cases can be successfully managed with the right expertise and care.
Our expert team includes four leading vascular surgeons: Dr Nedal Katib, Dr Andrew Lennox, Associate Professor Shannon Thomas, and Professor Ramon Varcoe. Their combined clinical and research experience in surgical and minimally invasive revascularisation techniques forms the foundation of our specialised care.
We recognise that many healthcare facilities lack the resources, time, or training to manage complex limb salvage cases. Our centre acts as a referral hub and partner, facilitating access to advanced treatments, extensive education, and when appropriate, coordinating or taking over patient care to optimise outcomes.
Our multidisciplinary model
- Vascular Surgery
- Orthopaedics – foot & ankle reconstruction
- Endocrinology – diabetes & metabolic
- Infectious Diseases – wound & infection control
- Podiatry
- Hyperbaric Oxygen Therapy
Everything needed to keep a threatened limb
Advanced Lower Limb Revascularisation
We offer expert open surgical and endovascular interventions to restore blood flow and preserve limbs.
DVA
A surgical/endovascular hybrid technique designed for patients with “No Option” or “Poor Option” CLTI. It reroutes arterial blood flow into the deep venous system of the leg to improve tissue perfusion when conventional arterial routes are blocked or unavailable. This approach has expanded limb salvage possibilities for patients who historically faced inevitable amputation.
Multidisciplinary Limb Salvage Programs
Coordinated care among vascular surgeons, orthopaedists, infectious disease specialists, endocrinologists, podiatrists and hyperbaric medicine experts to deliver comprehensive limb preservation treatment.
Hyperbaric Oxygen Therapy
Adjunctive therapy to accelerate healing in chronic ischemic wounds and ulcers by enhancing tissue oxygenation.
Referral and Care Coordination
We actively liaise with regional and local vascular centres to facilitate patient referrals, ensuring rapid access to the most appropriate care setting, whether at our centre or a partnering facility.
Patient Education and Support
Educational programs that give patients knowledge about their condition, treatment options, lifestyle changes and rehabilitation to promote the best outcomes.
Patient triaging
No Option CLTI
Patients with advanced peripheral arterial disease for whom all conventional revascularisation options have been exhausted or are technically unfeasible. These patients typically present with rest pain, non-healing wounds, or gangrene and historically have faced amputation as the only option.
Poor Option CLTI
Patients with severely limited but still potentially feasible revascularisation pathways due to anatomical complexity, comorbidities, or previous failed interventions.
Early and rigorous triaging
Early identification and comprehensive triaging of No Option CLTI patients are crucial. Our process includes:
- Detailed imaging
CT angiography, duplex ultrasound and angiography to assess arterial anatomy and evaluate treatment feasibility. - Multidisciplinary review
Vascular surgeons, radiologists, infectious disease specialists, endocrinologists and wound care experts. - Innovative options
Consideration of DVA and participation in clinical trials. - Risk–benefit analysis
Focused on limb salvage potential and quality of life.
This triaging ensures patients receive the most appropriate interventions and minimises unnecessary amputations.
Advancing vascular medicine
Our trials give patients access to cutting-edge therapies while advancing vascular medicine.
MDT Cohort Study – CVLS Study
Prospective Cohort Study Evaluating a Centralised Virtual Limb Salvage (CVLS) Clinic for the Management of Complex CLTI
A prospective observational cohort study tracking patients referred to our MDT clinic. It evaluates individual treatment pathways, limb salvage rates and overall patient outcomes to identify best practices and improve future care. The CVLS Clinic brings together specialist vascular experts on a regular virtual platform to review complex cases and advise on treatment, as per standard of care.
Who can participate?
- Adults over 18
- A new or non-healing wound on the foot or leg
- Lower limb CLTI or peripheral arterial disease (PAD)
- Diabetes mellitus
- Multiple failed attempts at revascularisation
What's involved?
- Case review by our specialist virtual MDT clinic
- Clinical information collected from medical records into a confidential study database
- Regular follow-up to monitor outcomes
Approved by the South Eastern Sydney Local Health District HREC (2026/ETH01058). To find out more, call 1300 192 748 or email info@limbpreservation.com.au.
Study flyer · PDF
LIFE-BTK
Assessing innovative below-the-knee interventions.
EFEMORAL
Exploring new therapies for femoral artery disease.
Additional studies
Evaluating novel endovascular devices, hybrid interventions and adjunctive treatments in CLTI.
Clinics and case meetings
High Risk Foot Clinic (HRFC)
- Frequency
- Monthly
- Purpose
- Review patients in the clinic with an Orthopaedic Surgeon and Vascular Surgeon present, agree the best management plan and monitor progress.
- Who
- Podiatrists, vascular surgeons, orthopaedics, endocrinologists, infectious disease specialists, hyperbaric medicine experts and referring clinicians.
MDT meetings
- Frequency
- Monthly
- Purpose
- Review complex cases, update care plans, discuss research findings and optimise patient outcomes.
- Who
- Lower limb revascularisation specialists and referring clinicians.
Submit a case
Referring clinicians are encouraged to participate and submit cases for discussion.
Vascular surgeons
Four surgeons, one focus
Our expert team includes four leading vascular surgeons. Their combined clinical and research experience in surgical and minimally invasive revascularisation techniques forms the foundation of our specialised care.
From left: Associate Professor Shannon Thomas, Dr Nedal Katib, Professor Ramon Varcoe and Dr Andrew Lennox at the Vascular Disease in Primary Care event, hosted by Prince of Wales Private Hospital.
Dr Nedal Katib
Vascular & endovascular surgeonA highly experienced vascular and endovascular surgeon based in Sydney. After training in Australia, New Zealand and Belgium, he now practises at St Vincent’s Private Hospital and Prince of Wales Private Hospital. He combines clinical care with active research and academic teaching at the University of New South Wales.
Dr Andrew Lennox
Consultant vascular & endovascular surgeonPractises at Prince of Wales Private Hospital. He holds a Master of Surgery and is a Fellow of the Royal Australasian College of Surgeons. His clinical interests include arterial, venous and lymphatic diseases, alongside research and education roles.
Associate Professor Shannon Thomas
Senior vascular & endovascular surgeonAffiliated with Prince of Wales Public and Private Hospitals and Sydney Children’s Hospital. A/Prof Thomas is a conjoint senior lecturer at UNSW with clinical and research expertise in complex vascular conditions.
Professor Ramon Varcoe
Senior consultant surgeonWith a PhD and Master of Surgery, Prof Varcoe is a senior consultant surgeon at Prince of Wales Public and Private Hospitals and Sydney Children’s Hospital. He directs The Vascular Institute, teaches at UNSW and leads vascular symposia.
Supporting specialists
Supporting our surgeons is a dedicated team providing comprehensive patient care:
- Orthopaedics – foot & ankle reconstruction
- Endocrinology
- Infectious Diseases
- Podiatry
- Hyperbaric Therapy
For patients and health professionals
We offer educational materials, guidelines, FAQs and links to vascular health organisations to support patients and healthcare professionals in understanding and managing critical limb ischemia and peripheral arterial disease.
Educational materials
Coming soon.
Clinical guidelines
Coming soon.
FAQs
Coming soon.
Vascular health organisations
Coming soon.
We welcome inquiries and referrals
Please use our contact form for appointments or general questions.