Q & A on Epoch Times – July 2016
Dr Cheng Shin Chuen
MBBSHons, FRCSEd, FAMS
Vascular and Endovascular Surgery
Dr Cheng attained his Vascular and Endovascular Surgery Fellowship at The Prince of Wales Hospital, Sydney.
His specialty interest is in minimally invasive treatment for a broad range of blood vessel diseases including Endovenous treatment for Varicose Veins, Angioplasty and stenting procedures, and aortic and peripheral vascular diseases.
He is a regional (South East Asia) trainer for the Stent treatment of complex aortic diseases and is a founding member of the Section of Vascular Surgery in the Chapter of General Surgeons, Singapore. He is also a Visiting Endovascular Surgeon to Tam Duc Cardiovascular Hospital in Vietnam.
1. Have you seen an increase in stroke and other vascular problems at your clinic?
Yes definitely there is an increase in the number of patients with vascular problems, anecdotally there is about a 15-20% increase year to year and patients are getting older, I have seen a fair number of patients in their 90s
2. Why do you think there is an increase in stroke and other vascular problems?
Vascular problems are mainly wear and tear issues with the blood vessels in our body. Prolonged exposure to high blood pressure, diabetes and high cholesterol all contribute. With a rapidly aging populartion we can only expect the numbers to go up.
3. How can we prevent stroke and other vascular problems? Who should go for screening?
Volumes have been written about healthy living and diet. All that is good and necessary but many people forget that the genes we get from our parents play a big part in increasing our risk of developing vascular problems.
I strongly advocate screening in the late 30s for high blood pressure and high cholesterol. Diabetes screening in the 40s will be helpful too.
The big three risk factors, high blood pressure, high cholesterol and diabetes; they all lead to major vascular problems like stroke, heart attacks and leg amputations.
Honestly, nowadays even the most basic health screening covers all these major risk factors, so one should get themselves checked early.
4. How do you screen for stroke and other vascular problems?
What I do for my patients for stroke screening is to work closely with my Neurology colleagues for risk factor reduction. I perform ultrasound studies on the arteries in the neck which supplies blood to the brain. Any early excessive thickening and tight narrowing detected needs either lifestyle and risk factor treatment or intervention.
5. What are the treatments you recommend for patients with stroke or vascular problems?
Prevention of problems is always better than treatment. This is only possible with screening and involving other professionals once problems are detected.
Prevention of vascular complications needs a whole team of doctors and allied health professionals to help our patients stay out of trouble.
I work regularly and closely with Diabetes specialists (Endocrinologists), Cardiologists, Neurologists, Foot and Ankle surgeons and Podiatrists to make sure my patients stay stroke free, heart attack free and amputation free.
6. Do you have any other thoughts to share about your area of specialty?
Endovascular surgery or minimally invasive vascular surgery has changed dramatically how we treat our patients. Medical device research has really driven this to deliver good outcomes without major incisions and stress.
However, despite how technology has advanced, I still feel our Singaporean patients need to have a mindset change; they need to see doctors to assess their risk factors when they are still “well”, not when the stroke or heart attack or toe gangrene happens.
Perhaps only then can we make another improvement on our clinical outcomes.