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WHY YOU SHOULD SEE A VASCULAR SURGEON, NOT JUST ANY DOCTOR, IF YOU HAVE PERIPHERAL ARTERIAL DISEASE (PAD)

Peripheral Arterial Disease (PAD)

PAD is not JUST a circulation issue. It is a serious, progressive, and potentially life-threatening condition that demands expert evaluation and management. Yet far too often, patients are referred to a range of specialists, Cardiologists, Interventional Radiologists, Podiatrists, Primary Care Physicians none of whom may have the training, tools, or long-term perspective to fully diagnose and treat the root cause: blocked arteries in the legs.

So what makes a vascular surgeon the right specialist for PAD? And more importantly, why can choosing the wrong type of physician have devastating and even irreversible consequences?

PAD Is Not a Symptom: It's a Systemic, Life-Altering Disease

PAD occurs when arteries in the legs become narrowed or blocked due to atherosclerosis. The result is a restriction in blood flow, depriving muscles and tissues of vital oxygen and nutrients. Left untreated, PAD can lead to:

• Non-healing wounds
• Tissue loss and gangrene
• Major amputations
• Increased risk of heart attack and stroke
• Premature death

In fact, studies show that PAD carries a 5-year mortality rate of up to 30%, rivaling many cancers[^1].

Yet despite this, many patients are misdiagnosed or underdiagnosed, often dismissed with vague labels like neuropathy, venous insufficiency, age-related pain. These oversights stem not from malice, but from a lack of specialized training and the consequences can be devastating.

Not All Doctors Are Created Equal

Patients often feel reassured when a doctor belongs to a big-name institution or wears the title interventionalist. But here's the uncomfortable truth: just because someone can perform a procedure doesn't mean they should.

There is a vast disparity in physician skill, experience, and judgment when it comes to PAD. A general cardiologist may be able to place a stent. A radiologist may be able to interpret an image. But PAD requires more than technical proficiency; it requires deep, nuanced clinical decision-making, long-term follow-up, and the ability to treat not just the blockage, but the entire vascular system.

And that's exactly what a vascular surgeon is trained to do.

The Role of the Vascular Surgeon: Breadth, Depth, and Continuity

Vascular surgeons are the only specialists who are trained in both open and endovascular procedures, giving them a full arsenal of options to treat PAD at every stage. Unlike other proceduralists, they don't rely on a single technique or device; they tailor the approach to the patient.

Most importantly, they see the big picture. They manage the entire arterial system, including the heart, kidneys, and brain. They monitor long-term progress. They handle complications. They know when NOT to intervene and when to act swiftly.

In contrast, patients treated by less experienced providers often suffer from:

• Incomplete revascularization
• Delayed wound healing
• Repeat procedures that fail to address the core issue
• Amputations that might have been prevented

Poor Physician Judgment Can Cost Lives

One of the most sobering realities in medicine is that not all decisions are made with the patient's best interest at heart. In a healthcare system increasingly driven by productivity metrics, referral relationships, and profit margins, patients are sometimes steered toward procedures or providers based on financial incentives rather than medical necessity.

In PAD, these misjudgments are not academic, they're life-and-limb decisions. A poorly placed stent can lead to re-occlusion. A missed diagnosis can allow an ulcer to turn necrotic. An unnecessary amputation can sentence a patient to a shortened, limited life.

And that's why experience matters. Judgment matters. And trust matters.

Why Dr. Polly Kokinos Should Be Your First Call

Dr. Polly Kokinos is a double board-certified vascular surgeon who has dedicated her entire career to the prevention, diagnosis, and treatment of peripheral arterial disease. Her patients benefit not only from her surgical skill but from her unwavering commitment to patient-centered care; care that prioritizes outcomes over profits, people over procedures.

Dr. Kokinos has seen firsthand what happens when PAD is treated too late or not at all. She understands the gravity of this disease, and the consequences of even one misstep. That's why she insists on thorough diagnostic workups, collaborative care with podiatrists and primary care providers, and most importantly, honest, compassionate conversations with patients and families. And,  that's why more independent private practice physicians in Santa Clara County refer more PAD patients to her than to all the other vascular surgeons in the valley combined. 

Not every story ends in a happily ever after. But with the right specialist, the right diagnosis, and the right care plan, many patients can walk longer, live fuller, and face their future with dignity; not despair.