Tag: Vascular Lab

Vascular Surgeon vs Phlebologist vs “Vein Specialist”

Posted on by Michael Kokinos

Why Varicose Vein Treatment Is Not the Same as Vein Care…

And Why That Difference Matters in Santa Clara County.

If you search “vein doctor near me”, “varicose vein treatment Santa Clara County”, or “best vein specialist San Jose”, you will be flooded with sponsored ads, glossy Instagram reels, TikTok videos, and national chain websites promising fast, painless, lunchtime vein fixes.

What those ads do not tell you—and cannot tell you in a 15-second reel—is the single most important truth in vein medicine:

Vein care is not the same as vein treatment.
And vein treatment is not cosmetic—it is vascular medicine.

This updated guide builds on our original 2016 blog to clarify what has become even more obscured over the last decade:

  • Who is actually qualified to treat venous disease,
  • Why outcomes vary so dramatically, and
  • Why South Bay Vascular remains fundamentally different from national vein chains operating in Santa Clara County.

What Is a “Vein Doctor” — Really?

Today, three very different categories of physicians commonly market themselves as “vein doctors”:

  1. Board-Certified Vascular Surgeons

  2. Phlebologists

  3. “Vein Specialists” (a marketing term, not a specialty)

To patients, these titles can look interchangeable. They are not.

1. Vascular Surgeons: The Gold Standard in Vein and Varicose Vein Treatment

Vascular surgeons are physicians specifically trained to diagnose, treat, and manage diseases of the blood vessels—arteries and veins—throughout the entire body.

Training Pathway (Non-Negotiable):

• 4 years medical school
• 5–7 years general surgery residency
• 2+ years dedicated vascular surgery fellowship
• Multi-day written and oral board examinations
• Ongoing recertification every 10 years

Only after this process can a physician earn ABMS Board Certification in Vascular Surgery—the highest credential in vascular medicine in the United States.

Why This Matters for Varicose Veins

Varicose veins are not cosmetic defects. They are often the visible symptom of:
• Venous reflux disease
• Deep venous insufficiency
• Post-thrombotic disease
• Pelvic venous pathology
• Mixed arterial-venous disease

Only a vascular surgeon is trained to:
• Diagnose all contributing vascular pathology
• Interpret comprehensive duplex ultrasound data
• Treat simple and complex disease
• Manage any complication, immediately and independently
• Provide long-term continuity of care

South Bay Vascular’s physicians do not “do veins on the side.”
Veins are vascular disease—and vascular disease is our core discipline.

2. Phlebologists: Limited Scope, Limited Training, Limited Accountability

Phlebology is not an ABMS-recognized medical specialty.

A phlebologist may be board-certified in something else—but their vein training typically consists of:
• Weekend courses
• Short professional development seminars
• Device-specific instruction

“Board certification” in phlebology is obtained through a written exam, without a residency or fellowship dedicated to vascular disease.

What Patients Are Rarely Told

• Phlebologists do not hold hospital privileges for vascular surgery
• They cannot independently manage complications
• They must send patients to the ER if something goes wrong
• They cannot treat arterial disease
• They are limited to surface-level cosmetic vein work

This is not an insult—it is a structural limitation of training.

Phlebology certification is not equivalent to ABMS board certification. It never has been.

3. “Vein Specialists”: A Marketing Category, Not a Medical One

The term “vein specialist” is often used by:
• Cardiologists
• Interventional radiologists
• Dermatologists

These physicians are highly trained in their own specialties, but vein treatment is typically adjunctive, not central, to their practice.

They may treat veins competently in selected cases—but they are not trained to manage the full spectrum of venous disease, particularly when complications, mixed pathology, or advanced disease is present.

Why National Vein Chains Fall Short—No Matter How Good Their Marketing Looks

National vein centers excel at:
• Google Ads
• Sponsored Instagram Reels
• TikTok visibility
• Volume-based protocols
• Template-driven care

They do not excel at:
• Individualized vascular diagnosis
• Complex venous disease
• Long-term outcomes
• Accountability beyond the procedure room

Most national chains:
• Are staffed by non-vascular specialists
• Follow rigid algorithms
• Emphasize throughput over judgment
• Separate diagnosis from treatment
• Outsource ultrasound interpretation

Medicine Is Not an Algorithm

Vein disease does not follow scripts.
It requires clinical judgment, experience, and deep diagnostic capability—especially when symptoms persist or prior treatments fail.

The South Bay Vascular Difference: Treatment, Not Transactions

1. An Unmatched Vascular Laboratory

Many centers talk about their labs.
South Bay Vascular built one of the most advanced vascular labs in Santa Clara County.

Our lab offers:
• Immediate availability
• Comprehensive duplex imaging
• Expert interpretation by vascular surgeons
• Integration into real-time treatment decisions

Ultrasound is not a checkbox—it is the foundation of accurate diagnosis.

2. True Multilingual Access — 10 Languages Spoken

Healthcare outcomes improve when patients are understood.

South Bay Vascular serves Santa Clara County in 10 languages, ensuring:
• Accurate histories
• Informed consent
• Cultural competence
• Trust across diverse communities

This is not a marketing bullet—it is clinical excellence.

3. Independent. Physician-Led. Outcome-Driven.

We are not owned by private equity.
We do not have quotas.
We do not treat veins that do not need treatment.

Our physicians:
• Decide what is medically necessary
• Treat patients—not spreadsheets
• Stand behind outcomes for years, not weeks

Why Ads Don’t Tell the Whole Story

TikTok cannot show:
• Diagnostic nuance
• Failed prior treatments
• Long-term recurrence rates
• Complication management
• Physician accountability

Google Ads cannot convey:
• Surgical judgment
• Experience under pressure
• The difference between care and treatment

Search engines reward authority over time.
So do patients.

A Final Word to Patients in Santa Clara County

If your veins hurt
If they are swelling
If you have skin changes
If prior treatments failed
If you want answers—not sales pitches

You are not looking for “vein care.”
You are looking for vascular treatment.

And that distinction matters.

If you or anyone you know suffers from painful, achy, discolored legs call today to schedule an appointment at South Bay Vascular Center and Vein Institute. 408-376-3626

Leading the Fight Against Vascular Disease In Santa Clara County for 30 Years.

WHAT IS “ENDOVASCULAR” SURGERY?

Posted on by Michael Kokinos

As a vascular surgeon, I perform two very different types of surgery: Open Surgery and Endovascular Surgery.

  • Open surgery is just as you might think!  It involves making an incision with a scalpel and using various tools like forceps, scissors, electrocautery, and needle drivers to expose and then repair specific structures.  Since the beginning of surgery itself, all surgeons, not just vascular surgeons, have been practicing open surgery.
  • Endovascular surgery is a recent development that only began in the 1990s.  Motivated by the desire to perform minimally invasive and less harmful interventions on the most sick and highest risk patients, pioneers in vascular surgery developed endovascular techniques.

Though the concept is simple, endovascular surgery now allows vascular surgeons to solve a multitude of problems with blood vessels very differently than they have in the past. Using advanced minimally invasive surgical techniques, vascular surgeons can treat many forms of vascular disease without the need to “cut-open” their patients to treat extraordinarily complex and in some cases life threatening diseases.

Endovascular surgical techniques utilize ultrasound (sound waves) to place the tip of a hollow needle into a blood vessel.  Once these hollow needles have been placed through the needle, we place a very stiff wire that allows us to advance large tubes called catheters into the vessel.  Catheters have many different functions depending on the situation and are used to re-establish blood flow in vessels that are diseased and or blocked.

For peripheral vascular disease, there are blockages in the legs of a patient that prevent blood flow from reaching the foot.  For peripheral vascular disease we can use balloons on the end of the catheter that are inflated to open a blockage.  If balloons do not work, then we can put a self-expanding metal mesh tube on the end of a catheter and then deploy it inside the blockage, thereby keeping it open.  There is also a technology called atherectomy which literally means cutting out plaque.  The atherectomy device has a cutting edge that sands down the plaque and then a suction function that removes all the debris.

For aneurysms, which are dilations of a blood vessel that can rupture, we use stent grafts, which are self-expanding metal mesh tubes that are lined with an impermeable fabric.  We place the stent graft above and below the aneurysm, thereby sealing it from the pressure created by the heart and preventing rupture.

At the end of these endovascular cases, the patient only has one or two 1 mm in size punctures over the arteries that were accessed.  Contrast this to the classic open surgeries where patients could have incisions up to 10 to 20 cm!  As a contemporary vascular surgeon, I take pride and joy in being able to offer both types of surgical interventions to my patients.  If you or your loved one may be suffering from vascular disease, please do not hesitate to call our office at 408-376-3626 to schedule an appointment today!