What Does a Vascular Specialist Do?

The vascular system at a glance

The vascular system is a closed loop. Oxygen-rich blood leaves the heart through the aorta and travels through progressively smaller arteries to deliver nutrients to every tissue in the body. After delivery, the blood returns to the heart through veins, where it is recirculated to the lungs to pick up more oxygen. The lymphatic system runs in parallel, carrying excess fluid and immune cells back into the bloodstream.

When any segment of this network is damaged or obstructed, the consequences can be local — a leg ulcer, swelling, varicose veins — or systemic, such as a stroke from a blocked carotid artery or a life-threatening rupture from an undetected aortic aneurysm. Vascular specialists are trained to evaluate the entire network and intervene when blood flow is compromised.

Conditions vascular specialists treat

On the venous side, vascular specialists treat varicose veins, spider veins, chronic venous insufficiency, deep vein thrombosis (DVT), pulmonary embolism follow-up, venous stasis ulcers, and post-thrombotic syndrome. These conditions often present with leg pain, swelling, ankle discoloration, restless legs at night, or visible bulging veins.

On the arterial side, vascular specialists manage peripheral artery disease (PAD), critical limb ischemia, carotid artery stenosis, aortic aneurysms (both abdominal and thoracic), aortic dissection, and renal artery disease. Symptoms can include leg cramping with walking (claudication), non-healing wounds, transient vision loss or weakness on one side of the body, and pulsating abdominal masses.

Vascular specialists also handle access procedures for dialysis, deep vein reconstructions, and vascular trauma. Many are trained in both open surgery and endovascular techniques, allowing them to choose the least invasive approach for each patient.

Procedures performed by vascular specialists

Office-based venous procedures include sclerotherapy (injecting a solution to close small varicose and spider veins), radiofrequency ablation and endovenous laser therapy (heating the inside of an incompetent saphenous vein to seal it), and stab avulsion phlebectomy (removing larger varicose branches through tiny incisions). Most of these are performed under local anesthesia with patients walking out the same day.

Hospital-based or surgical-center procedures include open surgical bypass for blocked arteries, endovascular stenting of carotid or peripheral arteries, endovascular aneurysm repair (EVAR and TEVAR), thrombectomy for acute clots, and arteriovenous fistula creation for dialysis access. Vascular specialists often perform diagnostic angiography in the same setting.

Diagnostic services are central to the specialty. Most vascular practices include in-house duplex ultrasound, which lets the specialist measure blood flow, identify clots, evaluate valve function, and map vein anatomy without radiation or contrast. CT angiography and MR angiography are used for more detailed imaging when needed.

How vascular specialists differ from related fields

Cardiologists focus on the heart and coronary arteries; interventional cardiologists may also treat peripheral arterial disease but typically refer venous and aortic work to vascular surgeons. General surgeons do not have the dedicated training in endovascular techniques or duplex ultrasound interpretation that vascular surgeons complete.

Phlebologists are physicians who specialize specifically in vein disease. Many are board-certified in another specialty and have completed additional venous training. Interventional radiologists also treat some vascular conditions, particularly venous interventions and some arterial procedures, and often work alongside vascular surgeons within larger health systems.

When should you see a vascular specialist?

Talk to your primary care physician or directly schedule a vascular evaluation if you experience: leg pain or cramping when walking that improves with rest; visible varicose veins causing aching, swelling, or skin changes; non-healing sores on the lower legs or feet; sudden swelling in one leg; transient episodes of weakness, numbness, or vision loss; a pulsating mass in the abdomen; or a known family history of aortic aneurysm.

Many vascular conditions progress silently for years before causing major symptoms. Screening ultrasounds are recommended for men over 65 with a history of smoking (for abdominal aortic aneurysm) and for patients with diabetes who have wounds that are not healing.

Find a vascular specialist on Vascular.com

The Vascular.com directory lists vascular surgeons, phlebologists, and allied specialists across the United States. Profiles include credentials, contact information, and — for premium listings — accepted insurance and detailed procedure offerings. Browse the directory to compare specialists in your area and reach out directly through their listing.