Hello. Dr Lau here again. Today I wanted to share some information about Varicose Veins.  Almost daily, my patients ask me “Dr Lau, what causes varicose veins and associated swelling in the legs and what can I do about them?”

Although every patient I meet is different, varicose veins are one of the most common conditions that I treat as a vascular surgeon and relate to a disruption of structures within the veins called valves.

Normally, veins have valves that allow blood to go from the feet to the heart and prevent the blood from pooling in the legs. When these valves become damaged, patients can develop varicose veins because of the higher pressure in the veins within the legs. Damage to the valves can occur from standing for extended periods of time at work or otherwise which increases stress on the valves.

Deep vein thrombosis otherwise known as a blood clot can also damage the valves irreversibly. Some patients do not stand for extended periods of time and/or have blood clots but still develop varicose veins and swelling. In these patients, genetic factors may play a role.

Due to advancements in our understanding of how the veins work and, in the technology, we use to treat veinous disease, vascular surgeons have much to offer patients with varicose veins and swelling. We always try a period of compression stockings which are effective for reducing swelling and varicose veins in up to 50% of patients. If compression stockings do not work, we can perform a procedure that heat seals or glues the veins in the legs closed so they can no longer leak. Finally, we can also investigate obstructions in the connections between the heart and the legs in the abdomen with both ultrasound and specialized x-ray machines.


A SPECIAL WORD OF CAUTION: Not all Varicose Veins are Cosmetic Problems. In fact, varicose veins can sometimes be the sign of a much more complex vascular condition and as such Vascular Surgeons are uniquely qualified to diagnose and evaluate the underlying causes for the formation of varicose veins.  Clinics focusing exclusively on the treatment of varicose vein often time underdiagnose the underlying causes of these varicose veins and physicians advertising as “Vein Specialists or Vein Doctors” should be carefully evaluated before being allowed to treat your veins. Medicare as well as most commercial insurance carriers have identified strict guidelines for treating varicose veins and your treating physician must carefully follow these guidelines before treatments will be reimbursed. Many cosmetic varicose vein clinics will encourage patients to pay for cosmetic procedures in cash to avoid the guidelines established by Medicare and most major commercial insurance companies so patients must make informed decisions prior to simply paying cash to have a cosmetic procedure done.

As a vascular surgeon, I am well versed in the ways to diagnose and treat venous disease. Please do not hesitate to call to schedule an appointment if you have either varicose veins or swelling in your legs! If you or anyone you love is suffering from Varicose veins, please call our office to schedule an appointment at 408-376-3626.


My name is Ignatius Lau, and I just joined South Bay Vascular Center as a vascular surgeon.  I grew up in Portland, Oregon, and then went to the University of Washington in Seattle, Washington, for college.  Afterwards, I went to Stony Brook University in Long Island, New York, for medical school and finished my training at the Icahn School of Medicine at the Mount Sanai Hospital in New York City.

Developing a passion for vascular surgery has been one of the most satisfying parts of my life.  I love the technical challenge of vascular surgery.  I love the ability to form long-term relationships with my patients and help lead them through challenging points in their journey to become stronger healthier people.

The scope of therapeutic options is growing so rapidly with advancements in technology in vascular surgery.  As such, I look forward to sharing these ways in which we as vascular surgeons can help patients on this blog!


Hi! Dr. Lau here again with South Bay Vascular. Today, I wanted to shed some light on one of the most common issues that we see in vascular surgery, non-healing wounds of the feet and toes. My hope is that after reading this blog you will have a better understanding of what causes leg wounds and ulcers; why sometimes they won’t heal on their own, and what we in vascular surgery can do to help them heal.

Ulcers, generally speaking, develop because of TWO main causes: nerve damage induced by diabetes and lack of blood flow. When patients have elevated levels of sugar in their blood with diabetes, the sugar forms toxic compounds that damage nerves in the foot. Consequently, the patient cannot feel injuries that would otherwise cause a normal patient to adjust position to stop the injury. With this loss of sensation ulcers form at the point of repeated injury that the patient cannot feel.

The second cause, a lack of blood flow, develops over decades in patients who smoke and who have high blood pressure and high cholesterol. These medical problems cause hardening and narrowing of the blood vessels, otherwise known as atherosclerosis.

In patients with diabetes, I coordinate carefully with my podiatrist colleagues who are experts in specialized footwear and surgical interventions that alleviate common areas of trauma. In patients with poor blood flow, I, as a vascular surgeon, can perform minimally invasive surgery to restore blood flow to the affected area. We use wires and specialized tubes to gain access to the blood vessels and then use balloons to break open the narrowing’s and self-expanding tubes called stents to keep the vessels open. Afterwards, we use a specialized x-ray machine called fluoroscopy to see that the narrowing’s have opened again to allow blood to flow back to the area. Patients usually leave to go home the same day with only a 2-millimeter puncture in their groin and are back to normal activity the day after surgery!

If you or anyone you know has a wound on their leg, foot or toe that hasn’t healed in more than two weeks, please call our office at 408 376 3626 to schedule an appointment.