Vein disease, also known as venous insufficiency, is a common medical condition that affects millions of people. It occurs when the veins in the legs cannot adequately circulate blood back to the heart, causing a range of symptoms, including swelling, pain, and changes in the appearance of the affected veins.
While vein disease is often not serious, some vein issues can lead to complications such as blood clots and skin ulcers if left untreated. If you’re experiencing symptoms of vein disease, it’s important to seek medical attention. But with so many types of vein doctors out there, it can be confusing to know which one to see.
Knowing what doctor you should see will significantly improve the success of your vein treatment. This blog will help you understand the different types of doctors who can treat vein diseases and how to determine which one is right for you.
TYPES OF VEIN DOCTORS
Most vein doctors fall into one of three subgroups that each have varying qualifications:
- Board Certified Vascular Surgeon
- Vein Specialist
None of these doctors are the same. There are differences in the area of expertise, and many in the field of vein health have not completed the same level of certifying examination.
Investing in yourself and getting educated if you have or are concerned about vein disease is important. This will help you find the right doctor before diagnosis and venous disease treatment should you be diagnosed with vein disease.
Let’s further examine each group of vein doctors and what their training means for your vein disease treatment and successful completion.
WHAT IS A BOARD CERTIFIED VASCULAR SURGEON?
A vascular surgeon is a specialist highly trained in diseases of the veins, arteries and lymphatic vessels. In short, they are experts on these blood vessels. They understand how each one works and what can go wrong with them and can help you manage vascular disease so you can live a long and productive life.
Vascular surgeons must complete four years of college (undergrad) and four years of medical school. Then, according to the American Board of Surgery, they must spend five to seven years in a surgical residency program where they must complete rigorous training and exams. The qualifying exam is a 6-hour multiple-choice exam, and the certifying exam is a 3.5-hour oral session.
Upon passing these exams, they become board certifications in vascular surgery. But it doesn’t end there; a board-certified vascular surgeon must repass examinations every 10 years.
Because of their extensive training, board-certified vascular surgeons are the only doctors who manage patients’ operative care, but they do more than just surgery. Board-certified vascular surgeons can provide complete pre and postoperative care to patients and can also treat vascular diseases with medications or other conservative means.
Vascular disease can sometimes be a long-term condition. Vascular surgeons are the best choice if you have vein disease because of their ability to build multi-faceted and long-term relationships with patients.
WHAT IS A PHLEBOLOGIST?
A phlebologist has medical training and expertise in treating various venous diseases. Specifically, phlebologists treat diseases like varicose veins, blood clot disorders, spider veins, and other minor vascular conditions.
The qualification standards to become a phlebologist are less stringent than those of a board-certified vascular surgeon. In fact, any physician who has performed a residency in a recognized American Board of Phlebology specialty and passes a written qualifying exam can claim board certification.
This title does not represent competence and training in surgical, vascular fields. It is very misleading if these physicians use this alternative board certification to allude that they possess a higher level of training in the field.
A phlebologist should only treat cosmetic vein issues and diseases, as they do not hold hospital privileges and are not prepared to manage and treat postoperative matters that may arise. Specifically, this means in the event of a problem, the patient would be sent to a hospital emergency room where a board-certified vascular surgeon would treat the patient.
WHAT IS A VEIN SPECIALIST?
The title vein specialist can be used by medical doctors who may be board-certified in their respective fields. For example, dermatology or cardiology, but will perform minor cosmetic vein procedures.
Vein specialists may have a board-certified qualification, but these titles represent their skill specific to their primary fields of training, not disease of blood vessels. They do not have specific enough training to diagnose and treat vascular disease. Adding cosmetic vein treatments into their field of practice is a way to supplement their business.
In contrast, vascular surgeons’ credentials allow them to treat various vascular conditions, which we will discuss next.
WHICH VEIN DISEASES SHOULD BE TREATED BY A VASCULAR SURGEON?
In most cases, you should have any serious vein ailments looked at by a board-certified vascular surgeon because these doctors have been highly trained in the vascular field.
Many vein diseases are easy to treat but can become life-threatening if left undiagnosed. As a result, patients who never get tested or choose unqualified doctors increase the risk of complications that could result in death or disability. You want a doctor with experience beyond treatments for varicose veins. Vascular surgeons are the only doctors that have this type of expertise.
Board-certified vascular surgeons can diagnose and treat all vascular diseases. Here is a list of the most common vein diseases a vascular surgeon is best suited to treat.
Varicose veins are a common condition most commonly found on the thighs and legs that are caused by weak or damaged vein walls and valves. Pools of blood cause veins to bulge. When these bulging veins become visible on the skin’s surface, they’re called “varicose veins.”
Typically, varicose veins cause your leg to swell and feel tired and achy. In most cases, they are not considered life-threatening. However, if left untreated, these veins may rupture, creating ulcers on the skin. Another serious risk of leaving varicose veins untreated is that you can develop blood clots and vein infections.
The type of vein doctor you should see if you have varicose veins will depend on your unique requirements and medical background. Vein doctors and phlebologists can treat some cases of varicose veins. However, a vascular surgeon has superior training and experience, allowing them to offer expert diagnosis concerning the cause of your malfunctioning veins.
Deep Vein Thrombosis (DVT)
Also called venous thrombosis, deep vein thrombosis (DVT) occurs when a blood clot develops in veins deep in your body because your veins are injured or the blood flowing through them is slow. Most DVTs happen in your lower leg, thigh or pelvis, but they also can occur in other parts of your body, including your arm, brain, intestines, liver or kidney.
DVT itself is not typically life-threatening. However, these blood clots have the potential to break free and travel through your bloodstream if not correctly treated. While some vein specialists are qualified to diagnose and treat DVT, it might be best to see a vascular surgeon since they have more extensive vein training. Additionally, some cases of DVT need to be treated in the hospital by a vascular surgeon.
Chronic Venous Insufficiency
Chronic venous insufficiency happens when your leg veins become damaged and struggle to send blood back up to your heart, sending some blood back down to collect in the veins.
Over time, CVI can cause pain, swelling, and skin changes in your legs. It is not considered life-threatening. However, if left untreated or not adequately treated, these damaged veins can cause serious complications, such as ulcers, bleeding, and deep vein thrombosis.
CVI is also a long-term condition; more severe cases of CVI might need to be treated with surgical procedures. For these reasons, a vascular surgeon would be the best vein doctor to see if you have CVI.
A pulmonary embolism (PE) is a sudden blood clot in your lung that can damage part of your lung and decrease oxygen levels in your blood. With proper diagnosis and treatment, PE is seldom fatal. However, untreated PE can be serious and lead to other medical complications, including death.
A vascular surgeon is the only vein doctor you should see if you have a PE. Other doctors that could treat PE include cardiothoracic surgeons and pulmonologists.
Peripheral Arterial Disease (PAD)
Peripheral artery disease, or PAD, is a form of peripheral vascular disease in which your arteries are narrowed and can’t carry as much blood to the outer parts of your body, such as your arms and legs, and is usually caused by an accumulation of plaque in the arteries.
PAD can be life-threatening if not properly treated by the right doctor because these blockages can restrict circulation to your limbs and organs. If you don’t get proper treatment, you could be more likely to have a heart attack or stroke. PAD can also lead to the possibility of needing to have a limb amputated.
A vascular surgeon is most qualified to diagnose and treat PAD. Especially considering that surgery is sometimes needed to route your blood flow around a blocked artery.
a venous ulcer, also known as a venous stasis ulcer. These ulcers on the leg or ankle are typically a result of advanced vein disease that can become a dangerous health condition.
Venous ulcer treatment focuses on treating the underlying vein disease; therefore, it is best to see a vascular surgeon if you have venous ulcers.
Buerger’s disease (thromboangiitis obliterans) is a rare disease of the blood vessels in your arms and legs that occurs when small blood vessels become inflamed and swollen.
If left untreated, advanced Buerger’s disease can lead to gangrene (tissue death) of your fingers or toes. Therefore, seeing a doctor like a vascular surgeon with superior knowledge and training in blood vessels is vital.
Blood clots are different-sized clumps of blood that occur when blood hardens from a liquid to a solid. They can form in the veins in your legs, arms and groin and can be dangerous as they can break loose and move to other parts of your body, including your lungs.
Because many blood clots are often a complication of an untreated varicose vein, a vascular surgeon is usually the best doctor to see. Sometimes surgery is needed. If not, the goal is to prevent blood clots from getting larger. A vascular surgeon specializes in treatment programs that can achieve this.
Lymphedema is an abnormal collection of lymphatic fluid in the body. It is a chronic disease that can be hereditary, but it can also occur after a surgical procedure, infection, radiation or other physical trauma.
Because the lymphatic vessels are a component of the circulatory system, patients who need medical care for lymphedema should see vascular specialists who treat arteries, veins and diseases of the circulatory system, such as a vascular surgeon.
Vascular pain typically occurs in the legs and is described as an achy sensation or an uncomfortable heaviness or throbbing sensation. The pain may be chronic, acute or sub-acute and range in severity from mild to debilitating.
If you are experiencing vascular pain, it is almost always due to issues with blood flow, which is one area of expertise for vascular surgeons. Another reason you should see a vascular surgeon if you are experiencing vascular pain is that this type of leg pain is often the first symptom of severe vascular diseases, such as peripheral artery disease (PAD), arteriosclerosis or deep vein thrombosis.
Different treatments may be recommended to relieve symptoms and treat underlying conditions depending on each patient’s condition. Many of these treatments should only be performed by a vascular surgeon.
An aortic aneurysm is a bulge in the wall of your aorta, the main artery from your heart that carries blood from the heart to the body.
Aortic aneurysms can burst or split, which can cause life-threatening issues such as internal bleeding or blocked blood flow from your heart to various organs.
Cardiac surgeons, interventional cardiologists, thoracic surgeons, and vascular surgeons most commonly treat aortic aneurysms and perform aortic aneurysm repair.
Carotid Artery Disease
Carotid artery disease causes a narrowing of the large arteries on either side of the neck. These major blood vessels carry blood to the head, face, and brain. It is considered a serious disease because left untreated, it causes a stroke due to a blockage in the brain.
Vascular surgeons are experts in managing carotid artery disease and, if needed, can perform carotid artery surgery to restore proper blood flow to the brain.
Renal Vascular Disease
There are many types of renal disease, one of which is vascular renal disease, which affects the blood flow into and out of the kidneys. It may cause kidney damage, kidney failure, and high blood pressure.
We’ve mentioned several of these vascular diseases above and can include:
- Renal artery stenosis (RAS) – A narrowing or blockage of an artery to the kidneys.
- Renal artery thrombosis – A blood clot in an artery that supplies the kidney.
- Renal vein thrombosis – The formation of a clot in a vein to the kidney.
- Renal artery aneurysm – A bulging, weak area in the wall of an artery to the kidney.
- Atheroembolic renal disease – When a piece of plaque from a larger artery breaks off and travels through the blood.
Any renal vascular disease should ideally be monitored and treated by a vascular surgeon. Treatment depends on the type of renal vascular disease. Patients with mild or moderate symptoms can often be treated with regular monitoring of blood pressure and kidney function and medication. Those with severe renal insufficiency or more severe symptoms might require surgery.
In addition to the vascular conditions mentioned above, there are many other concerns with how your veins carry blood that vascular surgeons can diagnose and treat.
WHAT ABOUT HIGH RISK PATIENTS? WHAT DOCTOR SHOULD THEY SEE?
You should also consider seeing a vascular surgeon for any vein concern, minor or severe, if you are considered at high risk for vein disease.
You might be considered a high risk for vascular disease if you…
- Smoke cigarettes
- Have diabetes
- Have kidney disease
- Have high blood pressure
- Have a history of vascular disease
High-risk patients should get regular screenings to catch and prevent problems. In addition, patients should also actively work with a board-certified vascular surgeon to properly maintain their health.
WHAT TYPES OF TREATMENTS ARE AVAILABLE TO BOARD-CERTIFIED VASCULAR SURGEONS?
A board-certified vascular surgeon has training and access to treat all types of vein disease and every kind of treatment and procedure available to patients. Other vein doctors can’t say this.
Vascular disease procedures range from a simple treatment for varicose veins using compression stockings to more invasive treatments like vein filters and stenting. Furthermore, vascular surgeons have hospital admittance and can care for patients from diagnosis through postoperative care.
Here are some of the treatments a vascular surgeon can provide. Some of these can only be performed by a vascular surgeon:
- Prescription compression stockings: These are a special type of sock that you can’t get “over-the-counter” that improves circulation.
- Medicines for blood flow, ulcers, and kidneys: The list of medications you might be prescribed is long and will vary based on what type of vein disease or vein issue you are diagnosed with. Most are formulated to improve circulation and can aid from the inside.
- Laser or radiofrequency ablation (RFA): A minimally invasive procedure to close off veins or remove them. The laser uses heat to destroy tissue and shrink the size of tumors, nodules or other growths in the body. This is not technically a surgery but does require specific skills and experience. A vascular surgeon is the most qualified to perform RFA.
This is a procedure used to eliminate varicose and spider veins. It involves injecting a chemical solution into the damaged vein. The solution causes the vein walls to swell, stick together and seal shut, stopping blood flow. As a result, the vein should fade within a few days or weeks.
- Ligation Surgery: This minor surgery is used to treat varicose veins. In short, it is the surgical tying of veins. The damaged veins are tied off through small incisions made in the skin in the affected areas. A vascular surgeon is the only vein doctor trained to perform this surgery.
- Vein Stripping: This is the surgical removal of veins after ligation. The vein is then stripped (removed from your body), so your healthy veins can take over to help restore normal blood flow. As with ligation surgery, a vascular surgeon should perform vein stripping.
- Ambulatory phlebectomy: A minor surgical procedure to remove small superficial veins, which are bulging varicose veins close to the skin’s surface. This outpatient procedure was developed by dermatologic surgeons, and some are qualified to perform ambulatory phlebectomy. However, a doctor specializing in vein health, such as a vascular surgeon, would be best suited to perform this procedure.
Beyond these treatments and surgeries, a qualified vein surgeon can also assist in a health plan that involves dietary changes, an exercise regimen, and the correct medications.
Inadequate vein care can result in hospital stays, loss of limbs, and loss of life. You must choose a doctor with full qualifications to recognize a vein disease and appropriately administer care to mitigate risks and future vein health issues.
Using advanced technology and high levels of training and practice, vascular surgeons can provide patients with more skilled care and options to improve their quality of life or act urgently to save it.
The care of your veins and your vascular system should be left in the hands of a vascular The care of your veins and your vascular system should be left in the hands of a vascular surgeon. Sadly, many “vein specialists” claim that they can deal with your vascular problem when vascular surgeons are the only specialty with specific training to manage the vascular conditions that can impact your life.
Your vein care deserves the very best. When performing your research, qualifications matter. Make sure your vein specialist is a board-certified vascular surgeon.
Dr. Bonau, Dr. Kim, and Dr. Lee are board-certified vascular surgeons at the Nashville Vein Centre. These surgeons specialize in vascular surgical procedures and practice minimally invasive methods whenever possible.
Their dedication to their practice ensures each patient receives a careful diagnosis, perfect treatment, and the best vascular procedures in Nashville. If you are experiencing leg discomfort, varicose veins, or any vein concern, you need to schedule a screening; please call us and schedule an appointment at (615) 503-9895.