Dr Yow Vascular Malaysia

07/09/2025

LONG WEEKENDS ARE MADE FOR THIS..

Nothing makes us better as a family after a tough week of fixing people than the sound of wind through the trees, the smell of new rain on the leaves, the roar and ice of mountain waters ...








There is a magical place just off the Bentong road which the missus found where the Forestry & Highways Department very wisely built 2 enormous monsoon tunnels to allow the mountain waters from the watershed & waterfall of Sungai Pisang to pass under the Karak Highway.

So the little man got his wild swimming in a crystal clear mountain stream..

In most other sad stories of development versus jungle in Malaysia, development always wins with damming, diversion or just obliteration of rivers...

Not this time... the jungle & Sungai Pisang got to stay & continue its life as a river...

And families like us get to feel we still we own parts of our beautiful country as it should be... free from shopping malls, concrete & cars... green & primordial...

In this climate crisis, all the more so..

Can we please keep our TREES...

01/09/2025

WHAT A WAY TO CELEBRATE MERDEKA DAY TO BE INVITED TO THE WEDDING OF SURAYA & ISKANDAR!

PROPER MUHIBBAH!

Suraya is my very capable Vascular Clinic Assistant at Sri Kota Specialist Medical Centre & it was a real joy to see her resplendent in her bridal gown on Merdeka Day yesterday!



It was a delight to celebrate her wedding with my family & the rest of Sri Kota staff including Krish & Nancy..

Seeing all races coming together in celebration of a colleague's happy day really makes me proud to be Malaysian!




Wishing Suraya & Iskandar Health & Happiness in all their years ahead... and a great Malaysian Independence Day to all fellow Malaysians...

26/08/2025

THE OPENING OF OUR HYBRID OPERATING THEATRE : WHAT A PRIVILEGE TO BE INVITED TO BE PRESENT AT THIS HISTORIC MILESTONE FOR SRI KOTA SPECIALIST MEDICAL CENTRE! AND A FIRST FOR PRIVATE HEALTHCARE IN KLANG!





WE ARE THE FIRST IN KLANG TO HAVE A HYBRID OPERATING THEATRE/HYBRID OT WITH PHILLIPS AZURION BI-PLANAR ANGIOGRAPHY & ONE OF 5 PRIVATE HOSPITALS IN ALL OF KLANG VALLEY (KLANG, SHAH ALAM, PJ & GREATER KUALA LUMPUR) TO HAVE THIS AMAZING FACILITY!

It was an honour to explain how the hybrid OT can be used to provide 21st century Vascular & Endovascular Surgery to the Mayor of Klang, YBhg Dato Haji Abdul Hamid Hussain.



We had a great speech from our CEO, Mdm Tan Suet Guan & the Mayor himself with the presence of our Board of Directors, Datuk Seri Nick Low, Datuk Wira Lim Kim Long & our MAC Chair, Dr Prakash.

I explained how hybrid Vascular & Endovascular Surgery has revolutionised treatment of Vascular patients by:

1. Shortening procedural times
2. Reducing physiological stress on patients
3. Allowing us to treat more elderly, frail patients
4. Allowing Bypasses & Angioplasty to be performed in the same theatre




In fact, my first hybrid case here involved the successful revascularisation & limb salvage of a frail 83 year old lady with foot gangrene. I performed an open leg/femoropopliteal bypass using her own saphenous vein in combination with angioplasty of her tibial(below knee) artery to save her leg.




15 years ago, she would have needed an open bypass from her groin to ankle lasting 8 hours, which she would not have survived. Instead, we did a hybrid operation that lasted just 6 hours in our new Hybrid OT at Sri Kota, Klang with my Complex Vascular team.








So conditions we can treat in the hybrid OT include :

1. Peripheral arterial disease in the legs
2. Aortic Aneurysms with aortic stenting (EVAR)





If you are concerned about any of the conditions above, do contact Dr Yow's clinic on 014 3302368.

21/08/2025

Recently, our Consultant Vascular Surgeon, Dr Yow Kuan Heng, successfully performed a complex carotid endarterectomy on a high-risk patient referred from a large private hospital in Penang.

Mr Eddy Giantono from Indonesia had a severe narrowing(stenosis) in the carotid(neck) artery on one side, had survived a heart attack, coronary bypass surgery & was living with moderate heart failure. Imaging also showed a 90% narrowing of the other carotid artery & blockage of large parts of his Circle of Willis, an important backup network of arteries in his brain.

Mr Giantono had had a minor stroke with mild left arm weakness. He was throwing off clot from a right carotid artery stenosis.

Without surgery, he was at risk of a major stroke or death.
Level 1 research shows that carotid endarterectomy is the 1st choice intervention to prevent this stroke.

𝙒𝙝𝙖𝙩 𝙈𝙖𝙙𝙚 𝙏𝙝𝙞𝙨 𝘾𝙖𝙨𝙚 𝙃𝙞𝙜𝙝 𝙍𝙞𝙨𝙠
• Site of the narrowing high & deep in the neck
• Abnormal rotation of carotid arteries making surgery difficult
• Previous heart surgery & heart failure
• Incomplete backup circulation in the brain
Despite these hurdles, our team moved with precision.

𝙆𝙚𝙮 𝙃𝙞𝙜𝙝𝙡𝙞𝙜𝙝𝙩𝙨 𝙤𝙛 𝙩𝙝𝙚 𝙋𝙧𝙤𝙘𝙚𝙙𝙪𝙧𝙚
• Placing a tiny tube(shunt) to keep blood flowing through the brain
• Removing a large, web-like plaque before it could break off & cause a stroke
• Carefully navigating a high, rotated carotid junction

Our carotid shunt time of 3 minutes equals internationally published times, helping to protect the brain faster.

𝙍𝙚𝙢𝙖𝙧𝙠𝙖𝙗𝙡𝙚 𝙍𝙚𝙘𝙤𝙫𝙚𝙧𝙮
• Patient was walking on Day 1
• Eating & drinking within 24 hours
• Discharged in 3 days
• Another potential stroke safely prevented.

Stories like this remind us why we push the limits of what’s possible in Vascular Surgery in our Major Vascular Unit at Sri Kota. We’re proud to bring complex care to patients, wherever they come from, & return them to their normal lives as quickly & safely as possible.

To book an appointment with Dr Yow Kuan Heng, click here:
https://www.srikotamedical.com/find-a.../dr-yow-kuan-heng/

17/08/2025

CHUFFED DAD MOMENT NO. 58 : BOY'S DAY OUT WITH THE LITTLE MAN WHILE MUM WAS AWAY.

A BREAK FROM FIXING PEOPLE : INTRODUCED THE LITTLE MAN TO HIS FIRST ROCK CLIMBING SESSION & HE TOOK TO IT LIKE A SPIDER ON A WALL!!








Proud is an overused word but heck, some days you've gotta use it.

So we had five walls with free climbing, abseiling, rappeling & everything in between & he took to it with excellent technique & was sensible about his limits... just like in Vascular Surgery ... a healthy dose of fear keeps you careful.. keeps you safe ...

And we had a blast of a time... And a reminder of how much I missed climbing..

Thank you to the fabulous lads(instructors) at Camp5 One Utama for a fabulous time..

As evidenced by famous last words, 'Daddy, when are we coming back?'

06/08/2025

Something we should all try to do ... wherever we live....

Plastic is a growing concern, so it’s time to cut back. Here’s how, from tips on reducing our use to ideas for more sustainable products

30/07/2025

EVERY DAY I AM IN VASCULAR SURGERY & MAKING PEOPLE BETTER.... I AM GRATEFUL...

FEELING GRATEFUL FOR THE CHANCE TO FIX PEOPLE IS WHAT KEEPS ME GOING...

There are challenging cases that take days to plan, legwork to prepare and then to push yourself technically 150 per cent ... and your team to achieve the best possible outcome for your patient..

Simply driven by the thought that with that good outcome, your patient will then take it forward into a meaningful, productive life.. THAT IS WHAT DRIVES ME AS A SURGEON..





So, I was very touched when my patient's wife, , spent her time while waiting for the outcome of her husband's operation, completing this beautiful work of art as a token of her gratitude for me & my team.

The case was a technically challenging & rare splenic artery aneurysm (Image 4,5 : Red arrows). The easy way out : Tie off the splenic artery & remove the spleen with the aneurysm.






Instead, we went the extra mile to mobilise the splenic artery (to create extra length), to splice the splenic artery ends together as a bypass after we had removed the aneurysms.




This saved the spleen. The spleen is a crucial organ for a person's immunity. Losing your spleen puts you at risk of life-threatening infections. Losing it means a lifetime of vaccinations & antibiotics.

By performing the splenic artery bypass, we had achieved 2 key objectives :
1. Prevented life-threatening rupture of the aneurysms
2. Saved the spleen

The 6-hours fly by in the adrenaline-driven focus for a successful outcome. The sight of a pink spleen once the bypass is running rivals the summit of any mountain I have ever climbed .... every time...

And when you peel off your sweat-stained surgical mask & loupes, often in exhaustion, I am reminded that I am grateful to able to do what I do...

Jenny's gift, created with her own hands, just made that feeling even stronger ... an attitude for gratitude..

30/07/2025

ARTERIAL ANEURYSMS CAN ARISE IN ANY PART OF YOUR ARTERIAL CIRCULATION.

YOU HAVE HEARD ABOUT AORTIC ANEURYSMS.. DID YOU KNOW YOU CAN GET AN ANEURYSM OF YOUR SPLENIC ARTERY?






So where in the world is the splenic artery?

You may have heard about the spleen, which is a pretty important organ which stores white blood cells & acts as a filter for infection & abnormal cells such as cancer cells. In short, it is crucial in your body's immune system.



The splenic artery is the main blood supply to the spleen. Like all arteries in the body, it can develop aneurysms.

An aneurysm is an abnormal dilatation of the artery, generally 1.5 times the neighbouring segment. This is due to a weakening in the arterial wall, rather like a blow-out in a car tyre.

Aneurysms are generally due to wear & tear but certain risk factors predispose their development.

For splenic artery aneurysms, these are:

Trauma
Inflammation eg pancreatitis
Infection
Family history




Splenic artery aneurysms are so deeply placed that you will have no symptoms until they burst. The result is severe abdominal pain & life-threatening internal bleeding.

Before rupture, all splenic artery aneurysms are picked up either incidentally during a CT scan for other conditions like gallstones or on a screening ultrasound scan.

This 43 year-old patient had the latter scan which detected a large 4.2 cm aneurysm(Images 1-3: Red arrows). As it was close to the hilum(entry to spleen), it was unsuitable to stent.

The only option was open surgery. I counselled him about the risk of pancreatic injury (splenic artery lies behind the pancreas). With the assistance of another Vascular Surgical colleague, we embarked on this hazardous & technically challenging procedure.

The easy way out: Tie off the artery & remove the aneurysm with the spleen(Splenectomy).

I am delighted we went the extra mile by performing a splenic artery bypass after excising the aneurysm(Image 4).We saved his spleen, which was crucial to his immunity & avoided a lifetime of vaccinations & antibiotics!

27/07/2025

Something we have been saying all along on this Page... what we should be doing in the 'heatwaves' that are the new normal.. Takeaway fact : Temperatures are 4 deg C lower in tree-lined housing areas.. Let's plant more trees!

Scientists say air temperatures could be reduced by 5C by planting more trees.

26/07/2025

Wow..

A new paper suggests that it takes far less exercise than was previously thought to lower blood sugar after eating.

21/07/2025

TIKTOK LIVE INTERVIEW WITH THE UCSI HOSPITAL SEREMBAN TEAM !

'VARICOSE VEINS: THE LINK TO LEG ULCERS & HOW TO TREAT THEM'

WHEN : THURSDAY, 24TH JULY 2025, 12.30 - 1 PM.
WHERE : LIVE ON TIKTOK

Join me this coming Thursday where I will explain :

How varicose veins can lead to long-term skin damage, including leg ulcers
Why you should never ignore them
How simple, safe, modern, minimally-invasive treatment can avoid such problems
How we can heal leg ulcers using methods above.










Modern endothermal ablation, foam sclerotherapy & compression bandaging are all recommended by evidence-based guidelines such as the National Institute for Health & Care Excellence (NICE) in the UK & the European Society for Vascular Surgery. It is used in all major Vascular units around the world.




These are now available at UCSI Hospital, a state-of-the-art hospital nestled in the foothills of Negri Sembilan. One of the newest, largest private hospitals in NS, it is also part of the UCSI Medical School campus.

Do join us this Thursday at lunchtime. This interview is specially for you, members of the public. I promise to keep it simple, jargon-free & inclusive. You can ask me any of your burning questions on varicose veins!

17/07/2025

ANOTHER STROKE PREVENTED !

A LANDMARK RARE CASE OF RADIATION INDUCED CAROTID STENOSIS/NARROWING OF THE CAROTID ARTERY IN THE NECK.




THIS WAS A TANDEM/DOUBLE CAROTID STENOSIS (IMAGE 2 : ORANGE ARROWS) WHICH WAS THROWING CLOT TO THE PATIENT'S BRAIN, CAUSING TIA'S/MINI-STROKES.

The patient was getting recurrent episodes of blindness in the right eye, one of the classic TIA symptoms. 10 years ago, he had had radiotherapy for nasal cancer.








HE WAS AT RISK OF A MAJOR STROKE.

I PERFORMED A CAROTID ENDARTERECTOMY TO REMOVE NOT ONE, BUT TWO RUPTURED PLAQUES & PREVENTED A MAJOR STROKE.





The case was made more complex by the fact that the radiotherapy had also damaged & narrowed all the other 3 arteries to his brain (carotid & vertebrals) (Image 2 : Yellow arrows).

This would only have been possible with the expert involvement of my NeuroVascular Anaesthetist, Dr Sham Kumar who monitored the patient's brain oxygen levels throughout using cutting-edge technology called cerebral oximetry.



After removing the carotid plaque, I then sutured a tissue-engineered biological patch to widen the carotid artery. Proof of science in action as Tissue-Engineered Vascular grafts were the subject of my research thesis in the UK. The result was a widened carotid artery with no further risk of stroke! (Image 4:Green arrows)

He was up & walking on Day One postop.



Today, thanks to the amazing Complex Vascular Surgery team at Sri Kota Specialist Medical Centre, he is back to work at one month. Major stroke prevented!




Tomorrow, along with Dr Sham, I will be presenting how we successfully performed this landmark case and the Level One evidence why surgery is first line treatment for carotid stenosis over stents. Come join us!