Frequently Asked Questions About Vein Disease & Vein Treatment


What do veins do?

Veins and arteries make up the circulatory system.

Your heart pumps blood out to your body through arteries and then, once the oxygen and nutrients are delivered, it is the job of the veins to transport blood back to the heart, so the whole process can start over again. Because veins have to pump blood up hill against gravity, they contain one-way check valves pointing toward your heart. When these valves go bad and become leaky, the whole system backs up causing varicose veins and/or symptoms.


How do I know if my veins have gone bad or are diseased?

80 million Americans have bad leg veins. By this I mean that the one-way check valves I mentioned above, are leaky. This results in your legs becoming engorged with blood. Symptoms include swelling, aching, itching, restlessness, or leg fatigue. You may also have varicose veins or non-healing ulcers on your leg too. 


​Do I have to have varicose veins in order to have vein problems?             

No. 20% of people with leaky valves in their leg veins have pretty normal looking legs. But, their legs can still have all or some of the symptoms mentioned above.  Patients and their caregivers are frequently fooled by this situation. If you have any leg problems at all, whether or not you have varicose veins, come in for a free consult with Dr. Nellestein and he will help diagnose and treat your problem.


Who performs my consultation?

Dr. Nellestein, our Board Certified Cardiovascular Surgeon performs all consultations personally.


Is Dr. Nellestein Board Certified?

Yes. Dr. Nellestein is a Board Certified Cardiovascular surgeon with over 25 years of intensive clinical experience. He is certified by the American Board of Thoracic Surgery, which is part of the American Board of Medical Specialties (ABMS). You should always make sure that your doctor has an ABMS board certification.

Who should come in for a consultation?

If you have any symptoms in your legs—aching, itching, throbbing, leg fatigue or heaviness, pain or burning.

If you have spider veins or varicose veins with or without symptoms.

If you have a strong family history of vein problems and any symptoms, with or without varicose veins.


Why do I need an ultrasound?

The ultrasound is done in order to precisely see where the valves in your veins have gone bad (become leaky), and to quantitate the severity. This is called “mapping” your veins. This information is required for correct treatment. Insurance companies also must see this information before they will approve your treatment.


Do I need a referral from my primary care doctor?

No. Just call 816-237-5974 or send us an email at and we will reach out to you.


How do I know if insurance will cover my treatment?

Insurance companies break down vein disease into two categories.

  1. Medically necessary

  2. Cosmetic


Insurance companies pay for all or a portion of, those procedures deemed medically necessary. They do not pay for cosmetic procedures. At NVI nothing will be done to you without your consent. Furthermore, all the financial details will be described to your satisfaction, before anything is done.


Do I need time off from work?

No. In a perfect world I suggest taking one or two days off but it is certainly not mandatory. The discomfort is minimal and generally very well tolerated. At NVI we understand that time off from work can be very inconvenient for a lot of people, so we manage our schedule to accommodate the patient as much as possible.


What happens if I need this vein for open-heart surgery?

Having performed thousands of open-heart operations over the past 20 years Dr. Nellestein has unrivaled insight into this question. Basically, these large, diseased varicose veins are not suitable for use in bypass surgery. They are so large, thick and diseased that they would prematurely fail and close up. So, there is no reason, from a cardiovascular expert's viewpoint, to delay treating the varicose veins.


Nellestein Vein Institute
1341 Village Drive
Saint Joseph, MO 64506
Phone: 816-323-4451
Fax: 816-897-3969

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