Your circulation
tells a story.
Let's read it together.
Steady hands, plain language, and a decade of mapping the hidden rivers beneath skin — from calves that ache after two blocks to necks that pulse with silent risk.
Understanding your condition
Three conditions account for most of what we treat. Each has a spectrum — knowing where you fall changes everything about the conversation.
Chronic venous insufficiency affecting 40M+ Americans
What you feel
Visible surface veins, minor aching, cosmetic concern only
What the scan shows
Not typically required at this stage
Standard treatment
Compression stockings (20–30 mmHg), leg elevation, walking program
Timeline
3 months of conservative care before insurance covers further treatment
Progression unlikely without lifestyle factors
What you feel
Persistent reflux on duplex ultrasound, leg heaviness, end-of-day swelling
What the scan shows
Duplex ultrasound confirms venous reflux — the report that tells us which valves are failing
Standard treatment
Endovenous thermal ablation (radiofrequency or laser) — a 45-minute in-office procedure
Timeline
Return to work same day; full recovery in 1 week
Risk of skin changes and ulcer if untreated over years
What you feel
Edema, skin discoloration (lipodermatosclerosis), open venous ulcers
What the scan shows
Comprehensive duplex mapping of deep and superficial systems
Standard treatment
Ablation of incompetent veins + compression therapy; wound care for active ulcers
Timeline
Ulcer healing: 6–12 weeks with treatment; without treatment, indefinite
Venous ulcers recur in 70% of untreated patients within 3 years
Not sure which stage describes you?
Take the 5-question screenerTreatment, plainly explained
Every patient gets the least invasive effective option — we never jump to surgery when a walking program or a catheter will do the job.
Conservative
First, always
By condition
Varicose Veins
Compression stockings 20–30 mmHg, leg elevation, walking 30 min/day
Carotid Stenosis
Antiplatelet therapy, high-dose statin, blood pressure <130/80, Mediterranean diet, smoking cessation
PAD
Supervised walking program 3×/week, cilostazol if indicated, cardiovascular risk factor control
Recovery
Immediate — no downtime
Outcomes
Prevents progression in most patients with mild-moderate disease
Considerations
Requires consistent daily adherence. Insurance typically requires 3 months before covering procedures.
Ideal for
All patients. Starting point regardless of severity.
Minimally Invasive
Targeted, precise
By condition
Varicose Veins
Endovenous radiofrequency or laser ablation — thin catheter heats and closes the failing vein from inside. In-office, 45 minutes.
Carotid Stenosis
Carotid artery stenting (CAS) — a mesh tube placed via a small wrist or groin incision, for patients at high surgical risk
PAD
Angioplasty and stenting — balloon inflates inside the narrowed artery; stent holds it open. Same-day discharge.
Recovery
1–2 weeks to full activity
Outcomes
Durable relief in 85–95% of appropriately selected patients at 2 years
Considerations
Not for all anatomy. Results depend on location and length of disease.
Ideal for
Moderate disease failing conservative care, or anatomy favorable for catheter approach.
Surgical
When it counts most
By condition
Varicose Veins
Phlebectomy — removal of surface varicosities through tiny 2mm incisions under local anesthesia. Often combined with ablation.
Carotid Stenosis
Carotid endarterectomy (CEA) — the gold standard. Plaque removed directly from artery under general or regional anesthesia.
PAD
Bypass surgery — your own saphenous vein harvested and used to route blood around the blockage. Lasts 10+ years in good candidates.
Recovery
2–8 weeks depending on procedure
Outcomes
Most durable option for complex or long-segment disease; CEA reduces stroke risk by >50%
Considerations
Requires general or regional anesthesia. Hospital stay 1–7 days. Best outcomes in experienced hands.
Ideal for
Severe disease, anatomy unsuitable for endovascular, or failed prior intervention.
A note from the surgeon
“Most patients who come to me expecting surgery leave with a prescription for compression stockings and a walking schedule. The ones who need procedures get procedures. My job is to know the difference — and to explain it in language that makes sense at the kitchen table, not just in the chart.”
From parking to care plan —
no surprises.
A first visit runs about 90 minutes. Here is exactly what happens, in order, so you can walk in knowing what to expect.
Arrival & Check-in
10 minParking is validated in the attached garage — bring your ticket to the front desk. Check in with our coordinator, who will verify your insurance and collect your referring physician's notes if you have them.
No referral required, but if your PCP ordered a duplex ultrasound, bring the disc or the printed report.
Medical History & Vitals
15 minA medical assistant records your blood pressure in both arms (a key test for PAD), oxygen saturation, and a brief symptom history. You'll complete a one-page questionnaire about walking distance, leg symptoms, and family history.
Please bring a list of current medications — especially blood thinners, statins, and blood pressure medications.
Vascular Examination
20 minThe surgeon examines your legs, feet, and neck — feeling pulses, listening for bruits (the sound plaque makes in a narrowed artery), and inspecting skin for changes that tell their own story.
Wear or bring loose-fitting shorts or pants that roll up above the knee. The exam is painless.
In-Office Imaging
20–30 minIn most cases, a duplex ultrasound is performed during your visit — no radiation, no dye, just sound waves mapping your blood flow. You'll see the images in real time as the technician scans.
If you've had a recent duplex elsewhere, we'll review it rather than repeat it. Bring the disc.
Consultation & Plan
20 minThe surgeon sits with you — no standing at the door, no rush — and draws your anatomy on a notepad, explains what the images show, and lays out your options in plain language. You leave with a written care plan.
Bring a family member or trusted friend. Two sets of ears remember more than one.
Checkout & Next Steps
5 minOur coordinator schedules any follow-up imaging, procedures, or referrals before you leave. We submit prior authorizations directly — you won't need to chase your insurance company.
Most first visits qualify as a new patient consultation. We'll provide a superbill for out-of-network reimbursement if needed.
Request your first appointment
We typically schedule new patients within 5–10 business days. Urgent referrals from physicians are seen within 48 hours.
Check your vascular health
Five questions. Two minutes. A clearer picture of where you stand — and what to do next.
How often do your legs feel heavy, achy, or tired — especially by evening?
This is the most common early symptom of venous insufficiency and PAD.
10,000+
Procedures performed
Board Certified
Vascular Surgery & General Surgery
< 5 days
Average wait for new patients