Endovenous Laser Ablation (EVLT), a treatment for varicose veins, is an advanced, highly effective treatment for varicose veins. EVLT works by using targeted laser energy to close off problem veins, thus relieving the symptoms and appearance of varicose veins and restoring healthy, attractive legs. This treatment is ideal for large varicose veins, including the greater saphenous veins.

The EVLT™ Procedure is minimally-invasive and virtually pain-free. While surgical vein treatment methods can cause scarring and other side effects, the laser energy used in EVLT minimizes risks and complications. Laser energy is delivered directly to the target vein to shrink the walls, which eventually causes the vein to close. Blood flow is diverted to other, healthy veins, eliminating the varicose vein bulging, discoloration, and pain.

EVLT is performed as an outpatient procedure, usually in less than an hour, with only local anesthesia. This means that recovery time is dramatically reduced. Most patients can resume normal activities immediately following treatment, while enjoying superior clinical and aesthetic results.


Radiofrequency ablation – the Closure Procedure – is similar to endovenous laser therapy. A radiofrequency probe is placed in the vein under ultrasound guidance. Then the vein is anesthetized using local anesthesia. Next, the vein is heated along its entire length by slowly withdrawing the probe from the vein. This causes the vein to clot and close, stopping the reflux (Leaking valves). Radiofrequency ablation is an outpatient procedure, can be performed under local anesthesia, and takes about 45 minutes. Possible complications are continued leg swelling, numbness, tingling, and blood clots in the legs. Patients may have bruising and mild pain for up to 4 weeks.

To date, Dr. Kokinos has successfully performed over 10,000 cosmetic vein procedures and is regarded as one of the premier Vascular Surgeons in the area to provide this service. If you suffer from painful varicose or unsightly legs, please call our office today to discuss your treatment options.

If you have already undergone a cosmetic vascular procedure and continue to experience pain and leg swelling, Dr. Kokinos is one of the few physicians in the area offering an FDA approved treatment to address this complication. We are happy to meet to evaluate your leg swelling, especially if it is left leg swelling and to discuss available treatment options for this unfortunate complication of cosmetic vein procedures.


The medical specialty of vascular technology utilizes diagnostic ultrasound to generate images of blood flow within the veins and arteries. Ultrasound uses high frequency sound waves, similar to the sonar that a ship uses to detect structures beneath the surface of the water. Vascular ultrasound can also be known as a Doppler or duplex study. For example, if your physician wants to make sure that you do not have a blood clot in your leg, he or she might order a venous duplex or venous Doppler examination.

Vascular ultrasound procedures are noninvasive, meaning they do not require the use of needles, dyes, radiation or anesthesia and are, therefore, relatively painless and harmless.

The information obtained through vascular ultrasound examinations is extremely helpful to physicians in diagnosing a variety of conditions related to cardiovascular disease, disorders of the heart and blood vessels. Early detection of life-threatening vascular diseases is possible through the use of noninvasive vascular testing techniques performed within vascular facilities.

Vascular ultrasound’s reliability in diagnosing conditions related to heart disease and stroke is encouraging as we strive for ways to reduce the more than 500,000 lives lost in the United States each year to these disorders. However, it is critical that the public realizes there are many facets that contribute to an accurate diagnosis based on vascular ultrasound examinations. These factors include the skill of the technologist/sonographer performing the examination, the type of equipment used, the background and knowledge of the interpreting physician and quality assurance measures. In fact, poor ultrasound examinations often lead to inconvenient, redundant studies, misdiagnosis and even unnecessary tests or surgery.

*Taken from the Intersocietal Accreditation Commission Website


Taken from the IAC Vascular Testing Accreditaton Website

IAC accreditation demonstrates a commitment to quality care.

The purpose of the IAC Vascular Testing accreditation program is “to ensure high quality patient care and to promote health care by providing a mechanism to encourage and recognize the provision of quality vascular diagnostic evaluations by a process of accreditation.” Through the accreditation process, facilities assess every aspect of daily operation and its impact on the quality of health care provided to patients. While completing the accreditation application, facilities often identify and correct potential problems, revise protocols and validate quality improvement programs. Because accreditation is renewed every three years, a long-term commitment to quality and self-assessment is developed and maintained. Facilities may use IAC accreditation as the foundation to create and achieve realistic quality care goals.

IAC accreditation provides a confidential peer-review.

Designed to serve facilities as an educational tool, IAC accreditation is made up of two crucial steps. First, facilities conduct a detailed self-evaluation using the IAC Standards and Guidelines for Vascular Testing Accreditation and the Online Accreditation application. Completion of the application requires detailed information on all aspects of facility operation as well as the submission of actual case studies for review. The case studies are crucial in determining the facility’s compliance with the IAC Standards, and are the basis for judgment of the quality of work that facilities perform. Once the self-evaluation is completed, the documents and case studies are reviewed by the IAC Vascular Testing Board of Directors. All aspects of the review are confidential.

IAC accreditation is a recruiting tool.

Accredited facilities can use their accreditation as a recruiting tool to attract the best and brightest physicians, sonographers and technologists. Talented professionals look for high-quality programs, and accreditation assures potential employees that a facility is dedicated to achieving the highest standards for patient care.

IAC accreditation is intersocietal.

The intersocietal, multi-specialty approach is the foundation of the accrediting divisions under the IAC umbrella. IAC Vascular Testing is a nonprofit organization established with the support of the sponsoring organizations. Representatives from these sponsoring organizations, including physicians, sonographers and technologists, serve on the IAC Vascular Testing Board of Directors. All areas of vascular testing were represented on the Board during the creation of the Standards for accreditation, and all areas continue to steer the accreditation process.

IAC accreditation is proven successful.

Offering accreditation for more than 20 years, the IAC Vascular Testing (formerly ICAVL) pioneered the intersocietal approach to imaging accreditation in 1990, as the first of the Intersocietal Accreditation Commission (IAC) divisions to be developed. Today, reimbursement in more than 30 states hinges on either facility accreditation or technologist certification. The number of IAC Vascular Testing accredited facilities in the U.S., Canada and Puerto Rico continues to grow, with more than 2,600 sites currently holding the accreditation. The IAC offers multi-modality accreditation through its programs dedicated to Vascular Testing, Echocardiography, Nuclear/PET, MRI, CT / Dental CT, Carotid Stenting, Vein Center and Cardiac Electrophysiology.

IAC accreditation demonstrates accountability.

Health care organizations are held to very high levels of accountability, by peers and by the general public. In numerous states, reimbursement directives that require accreditation of the facility have been instituted by Medicare carriers as well as private, third-party insurers (please visit Payment Policies section for the current list). Similar draft payment policies are pending throughout the United States. Facilities attaining accreditation before it is required for reimbursement demonstrate a willingness to surpass current expectations. The general public and members of the vascular testing community will recognize an unmatched commitment to providing quality health care by facilities that achieve IAC accreditation.


Both invasive and non-invasive (i.e surgical and non-surgical) methods are available to treat varicose veins. Non-invasive methods include wearing compression stockings, exercising, leg elevation, losing weight, not wearing tight clothes, avoiding long periods of standing or sitting and not crossing your legs while seated. Invasive treatments include endovenous therapy, ligation, and phlebectomy.

Endovenous therapy is treatment from inside the vein using heat generated by lasers, radiofrequency devices or chemicals to irritate the vein walls and cause the vein to close and then be reabsorbed by the body. Ligation is tying off a vein to cause it to shrink. Phlebectomy is removal of varicose veins. Only after your physician evaluates a patients vascular ultrasound study are they in a position to discuss the best treatment option for their patients. The vascular surgeons of South Bay Vascular Center and Vein Institute have successfully treated tens of thousands of varicose vein patients in their 20 year history of serving the silicon valley community. With offices in Campbell and Morgan Hill, Dr. Kokinos and her staff are honored to meet with you to discuss any questions you may have regarding varicose veins or any other circulatory related medical condition. Please call our office today to schedule an appointment to help us evaluate your treatment options. 408-376-3626


One of the questions I am most often asked when doing screenings for vein disease is “Is treatment covered by insurance?” As usual, most medical questions are not easily answered and so the answer is yes, and no. All insurance companies consider varicose vein disease treatments medically necessary, and will therefore cover it, if there are complications such as bleeding or ulceration. Most consider treatment medically necessary if there are symptoms and reflux can be demonstrated on a Doppler exam. Of course some of the newer treatments are considered “experimental” and therefore not covered. Spider vein treatments are considered cosmetic and no longer covered by any insurance plans of which we are aware. Lastly, not only does each insurance company have its own requirements but each individual policy can vary within the general guidelines of the company. Sounds confusing and it is. The best way to find out if your particular situation meets the requirements necessary for insurance coverage is to come in for an evaluation. Call us at 408-376-3626 to schedule an appointment to discuss your options.


During the months of May and June, in order to help our patients who have been suffering with left leg swelling for a long period of time, we are offering a free iliac vein ultrasound screening. This ultrasound will be offered on a limited basis to our current patients or someone who has a history of a DVT (deep venous thrombosis). These screenings need to be done in the early morning in fasting patients, and cannot be done on those who weigh more than 250 pounds. Please call our office at 408-376-3626 to inquire about availability of the free limited openings.


It is amazing to me how many patients we see who have suffered with leg swelling or wounds for months or years. They believe that it will just go away, or that the wound will just heal. Sometimes, they have even gone to their doctor, who usually does not even look at their leg. Although mild ankle swelling can sometimes occur just because the weather has been hot, or you have been sitting for a long time, or you had a lot of salt in your diet, the vast majority of the time, there is actually an underlying reason for the leg swelling. This can include such “big” problems such as a heart or kidney problem, a blood clot that has not been diagnosed (especially after an orthopedic procedure or a long car or plane trip), a tumor that is compressing your abdominal or pelvic vessels, or leaky valves in your veins. It is truly important to seek expert help from a vascular surgeon if your leg swelling extends up into your calf, or if it lasts more than a couple of days. This is especially true if it is painful. That is most commonly the sign of a deep venous thrombosis (DVT) and those must be treated immediately to prevent the blood clot from going to your lung and potentially killing you. Pulmonary embolus, when the clot travels to your lung and blocks a main artery there, is the number three cause of death in the United States that nobody talks about.

The work-up for leg swelling almost always will involve a leg ultrasound. This is a painless, quick, and inexpensive test that is diagnostic both for blood clots and leaky valves in the veins. Sometimes, if the problem is in the abdomen or pelvis, an ultrasound or CT scan there may be necessary. If the problems relates to a kidney or heart issue, blood work may be in order. In any case, sometimes, the treatment of the underlying problems that cause leg swelling need to be begun within a few days of its occuring so that one can have the best outcome possible.

If you have a swollen leg, whether it is for a few days or several months, come see the experts at South Bay Vascular Center to help diagnose and treat its cause.


South Bay Vascular Center and Vein Institute is pleased to announce the launch of their new website. The new site is designed to offer patients an easy to read, customer friendly option for interacting with our practice. Our goal with the new site is:

  • To provide our patients and prospective patients a more complete understanding of our practice; who we are and what we do.
  • To help educate our patients on the available options for the diagnosis and treatment of their vascular medical issues.
  • To improve our customer service for patients by giving them the ability to submit their insurance information on line, in advance of their visit, in an effort to both streamline their visit and to verify coverage.
  • To provide a portal through which patients can download all of their check-in and registration documents, as well as their pre-operative and post-operative medical instructions directly from the website.

South Bay Vascular Center and Vein Institute is proud to celebrate its 20th year serving the patients of Silicon Valley, South County and beyond. With the opening of our new angiography suite in Campbell, CA. our practice continues to be on the cutting edge of Vascular medicine. Advancements in medical imaging and devices have enabled our surgeons and interventional radiology partners to treat circulatory issues in our new state of the art center in ways that were never before possible, greatly enhancing our ability to serve the vascular surgery needs of our patients.

Dr. Kokinos, a nationally recognized ABMS Board Certified General and Vascular Surgeon, and her staff are pleased to meet and to discuss treatment options for all your vascular related issues. If you suffer from leg swelling, non-healing ulcers and wounds, experience complications following cosmetic vascular procedures (varicose and spider veins etc) have been diagnosed with a Blood Clot or DVT, we are here to help.

Don’t continue to suffer alone…we can provide guidance and help when you feel like there are no answers to your medical condition. Give us a call to discuss your treatment options and we can help you “Get your life back.”


Type “Varicose Vein” into Google search and in seconds, countless thousands of links pop up; each one pointing to a different website; each website claiming that their “Vein Doctor” is the “best”; and each practitioner promising to rid you of your ugly, painful veins, leg swelling and non-healing ulcers. Lost in this hype, finding the right physician might seem impossible. When everyone in cyberspace claims to be the best and backs up their claims by citing an endless list of credentials, professional affiliations and most importantly, showing off their work: their before and after galleries… it gets confusing.

Choosing the best doctor for your specific condition can be a difficult decision and should only be made after serious consideration of the available options. In the best of scenarios, patients should visit as many doctors as they can; to interview and to question them about everything relating to their condition. In these visits, patients are encouraged to evaluate everything from the reception staff to the vascular ultrasonographer; is your vascular ultrasound done “in-house”..is the ultrasonographer a registered ultrasound technologist…or are you sent to the hospital for an ultrasound. All of this makes a difference because your doctor will make their diagnosis on the basis of your ultrasound report. Ultrasounds must be read by a RPVI registered physician, not simply a radiologist… as the two physicians will look for vastly different signs relating to vascular disease and health. Keep in mind if the study isn’t read correctly, the procedure can go poorly.Patients should also pay special attention to the medical assistants, the nurses, the quality of the facility and ultimately, to the doctor themselves. As simple as this may sound, getting comfortable with and trusting your physician is unquestionably the most important part of the entire process. If the answer to any of your questions isn’t to your liking, ask a second and a third question for clarity. If you are still not satisfied, take the time to seek out another health care professional. Most importantly, keep in mind that on-line internet reviews and rankings mean nothing unless you, yourself, feel comfortable in the presence of your doctor. Take the time to choose wisely.

Doctors must earn a patient’s trust by ensuring that their patients understand their options, the risks of doing the surgery, and the expected outcomes from the procedure. If your doctor doesn’t seem to have enough time for you or your feel like you are being fed into a “treatment machine”, stop and go somewhere else. Remember, even though your goal is to correct your varicose veins, every cosmetic procedure carries with it a certain amount of risk; up to and including death. While many Varicose Veins are stand alone conditions, they can also be the expression of a much more complicated underlying circulatory problem. Ensuring your physician has the proper qualifications and experience to deal with ANY underlying circulatory issue, aside from the varicose vein itself, should be a vital part of your decision…and just because you doctor has done a lot of procedures, it doesn’t mean that the outcomes have been good. Ask them the tough questions….ask them what happens if your legs continue to swell after the procedure, what they will do? Just telling you to continue wearing compression stockings isn’t always the right answer. Ask your physician to show you the results of your ultrasound study and to explain why they believe the varicose vein is only a cosmetic issue and not a systemic issue. If the answer doesn’t seem right to you, it probably isn’t.

Who is the right person to call? What training should your “Varicose Vein Doctor” have? Always ask the question, “What happens if something goes wrong during the procedure?” Does the doctor you are interviewing for your procedure have the necessary training and qualifications to treat these problems? If you do need to be admitted to a local hospital if the unexpected happens, does your doctor have the RIGHT admitting privileges there to help you? If they answer that you will be sent to the ER, they clearly do not have the correct privileges…and this should be an important warning. If they say that they have done hundreds, maybe thousands of these procedures without a complication, and that there is nothing to worry about, be aware that every procedure has a potential for unexpected complications.

Dr. Kokinos is a ABMS Board Certified General And Vascular Surgeon with extensive training in the diagnosis and the treatment of vascular disease. Her award winning South Bay Vascular Center and Vein Institute is the South Bay’s largest Vascular Surgery practice specializing in the treatment of vascular disease, including Peripheral Arterial Disease (PAD) Leg Swelling, the Treatment for DVT’s, and Varicose Veins. If you or anyone you know suffers from any of the conditions listed above, or have had complications with cosmetic vein procedures, Dr. Kokinos is happy to discuss your treatment options.