Custom-Fit Procedures for Personalized Care

Board-certified in vascular and endovascular surgery, our doctors are experts at minimally invasive and hybrid procedures. Endovascular surgery is a type of minimally invasive surgery that accesses different regions of the body through a major blood vessel percutaneously. Hybrid interventions combine surgical and endovascular techniques in a single procedure and are performed in a specially equipped operating suite. Our in-house technology and breadth of surgical experience allows us to custom-fit the procedure to the patient, so every person we care for gets an individualized treatment plan. We specialize in a broad range of vascular surgeries:

  • Aortic Aneurysm Repair
    Aortic aneurysms can occur in the chest (thoracic aortic aneurysm) or more commonly, in the abdomen (abdominal aortic aneurysm, often called AAA or “triple A”). Most often, they can be repaired with a minimally invasive procedure called endovascular stent grafting—also known as endovascular aneurysm repair (EVAR). This surgery requires only an overnight stay in the hospital. We also address more complicated aneurysms, which require open surgery or hybrid repair. 
  • Minimally Invasive Procedures for Deep Venous Thrombosis (DVT)
    DVT procedure options include vena cava filter implantation and clot thrombolysis. Some DVT can be removed through catheter-based techniques. These surgeries can lower the risk of fatal pulmonary embolus and reduce the risk of chronic leg swelling and skin damage. Our team also helps patients with long term medical management and surveillance for DVT.
  • Treatment for Peripheral Arterial Disease (PAD)
    PAD can be treated using a variety of angioplasty techniques (minimally invasive procedures to open the artery from the inside using a balloon) as well as bypass surgery. Our operating suites are equipped with the latest technologies, such as:
    • Cryoplasty® (destroys arterial plaque through the use of a balloon catheter filled with nitrous oxide)
    • Intravascular ultrasound (employs a mini-ultrasound probe to see arteries from the inside)
    • AngioJet® (loosens and removes blood clots)
    • Cutting balloons (can be used to score the surface of arterial plaque and increase the efficacy of angioplasty
  • Limb Salvage Treatment for Extremity Trauma and Gangrene
    Our vascular team works in concert with the Marin General Hospital trauma, orthopedics, and plastics services to treat patients suffering from major trauma to the legs or arms. This multi-specialty approach has a proven track record of salvaging limbs and avoiding amputation. We also combined forces with plastics, wound care, infectious disease, and podiatry services to develop an integrated team for treatment of gangrene and major wounds to the extremities. Our mission is the preservation of function and quality of life. As a result of the success of both of these programs, we have become a referral center for complex limb salvage in the North Bay.
  • Varicose vein treatments
    We are a Bay Area leader in the treatment of varicose veins. We offer the Venefit™ Procedure for the ablation of varicose veins (see special section). We also specialize in sclerotherapy treatment for spider veins. We obtain insurance coverage for most vein procedures.
  • Dialysis access surgery
    Arteriovenous fistulas are the best long-term access for hemodialysis. Our team consistently exceeds the goals set by the Centers for Medicare and Medicaid Services (CMS) for the Fistula First Breakthrough Initiative. Our remarkable success rate with dialysis access is dependent on careful mapping prior to the procedure, routine ultrasound surveillance afterwards, close communication with nephrologists and the dialysis center, and the ability to salvage failing accesses with targeted endovascular techniques.
  • Carotid surgery
    Endarterectomy (the surgical removal of plaque from the carotid artery) remains the gold standard for treatment of severe carotid disease. (Some patients with carotid disease are better suited for carotid stenting, which is performed by our multi-specialty team.)

New Treatment for Varicose Veins

Our Vascular Program offers the Venefit™ Procedure for superficial venous reflux disease. Varicose veins are the most obvious symptom of superficial venous reflux disease, but patients also experience pain, swollen limbs, leg heaviness, fatigue, skin changes, and skin ulcers. The traditional treatment—vein stripping—can be quite painful, making the Venefit™ Procedure a welcome alternative. Performed on an outpatient basis, the Venefit™ Procedure closes the diseased vein by heating it from the inside. A closure catheter is inserted through a small opening in the skin and guided up to the affected vein, where it heats the vein wall using radiofrequency (RF) thermal energy. This shrinks the vein and seals it closed so blood can be rerouted to healthy veins.

The Venefit™ Procedure delivers positive outcomes in the following ways:

  • Symptom relief for pain, swelling, leg heaviness, and fatigue
  • Cosmetic improvement, noticeable after just one week
  • Rapid recovery, with most patients walking immediately after the procedure