Vascular Medicine vs. Hematology vs. Vascular Surgery: How We Work Together to Care for the Vascular System

Most patients — and even many clinicians — don’t realize that vascular medicine exists as its own specialty. Yet vascular disease is everywhere: leg swelling, blood clots, circulation problems, non-healing wounds, vein disorders, and complex cardiovascular risk. These conditions affect millions of people, and they require a clinician who understands the entire vascular system, not just one piece of it.

That’s where vascular medicine comes in.

Board-certified vascular medicine specialists are rare in the United States, but our role is central to patient care. We bridge the gap between cardiology, hematology, primary care, and vascular surgery, ensuring that patients receive comprehensive, non-surgical, evidence-based management of vascular disease.

Patients often ask: “Should I see vascular medicine, hematology, or vascular surgery for this?”
The answer depends on the problem — and in many cases, all three specialties play a role.

Here’s a clearer, more accurate way to explain the differences and the collaboration.

Vascular Medicine

Focus: Vascular medicine focuses on the diagnosis, prevention, and medical management of diseases affecting the arteries, veins, lymphatics, and microcirculation. It is a specialty grounded in physiology, imaging, and long‑term vascular health — with an emphasis on treating the whole vascular system, not just isolated symptoms.

While many people associate vascular care with leg swelling or varicose veins, the true scope of vascular medicine is far broader — spanning arterial, venous, lymphatic, microvascular, compressive, and complex systemic disorders:

• Peripheral artery disease (PAD)
• Aortic and peripheral aneurysms
• Carotid artery disease
• DVT/PE (including complex or recurrent cases)
• Unexplained leg swelling or discoloration
• Vasculitis and inflammatory arteriopathies
• Thermal and Microvascular Disorders such as Raynaud’s phenomenon and Erythromelalgia
• Microvascular dysfunction
• Lymphedema and complex limb swelling
• Thrombosis and Anticoagulation
• Compressive and Structural Syndromes (such as thoracic outlet syndrome-nerve or vascular compression at the shoulder)
• Collagen Vascular and Arteriopathies (including fibromuscular dysplasia-non‑atherosclerotic arterial disease often missed for years)
• Other Complex or Atypical Vascular Conditions (such as lipedema-a fat‑distribution disorder often mistaken for obesity or lymphedema)

Approach:

• Physiology-driven evaluation
• Advanced vascular imaging
• Medical therapy
• Risk-factor optimization
• Long-term management and prevention

What sets vascular medicine apart:

• We manage both the vascular consequences and the underlying drivers of disease.
• We evaluate and treat complex clotting disorders, especially when they intersect with hormones, cancer therapies, autoimmune disease, or vascular anatomy.
• We collaborate with hematology when blood-based conditions contribute to clotting risk — but we remain central in managing the vascular impact, recurrence prevention, and long-term outcomes.
• We follow patients over time, often becoming their “vascular home base.”

In short: Vascular medicine treats the whole vascular system and stays with the patient long-term.

Hematology

Focus: Disorders of the blood, bone marrow, and coagulation pathways.

Approach:

• Cellular and genetic evaluation
• Coagulation studies
• Management of blood cancers and marrow disorders

Where hematology and vascular medicine overlap:

• Thrombophilia evaluation
• Anticoagulation decisions
• Cancer-associated clotting
• Platelet disorders affecting clotting or bleeding

Key distinction:

• Hematology focuses on why the blood clots.
• Vascular medicine focuses on where the clot forms, how it affects the vascular system, and how to prevent long-term complications.

In practice:
Many patients benefit from both specialties — hematology for the blood disorder, vascular medicine for the vascular consequences and long-term management.

Vascular Surgery

Focus: Surgical and endovascular treatment of arterial and venous disease.

Approach:

• Technical expertise in procedures such as angioplasty, stenting, bypass, and vein ablation
• Management of limb-threatening ischemia, aneurysms, carotid disease, and complex venous disease

Important nuance:
While vascular surgeons are procedure-trained, they also provide longitudinal vascular care. Many follow patients closely before and after interventions, manage wounds, and monitor disease progression.

Where our approaches differ:

• Vascular surgeons are trained to solve problems through technical intervention.
• Vascular medicine is trained to solve problems through medical optimization, physiology, and long-term prevention.

Both perspectives are essential — and complementary.

How These Specialties Work Together

The best vascular care happens when these disciplines collaborate:

• Vascular medicine identifies the vascular problem, interprets imaging, manages medical therapy, and follows the patient long-term.
• Hematology evaluates underlying blood disorders and guides complex coagulation decisions.
• Vascular surgery intervenes when anatomy or disease severity requires a procedure — and continues to follow patients afterward.

This interplay ensures that patients receive the right treatment at the right time, without unnecessary procedures or missed diagnoses.

Why Vascular Medicine Is Often the First Stop

Because vascular disease is multifactorial, subtle, and often misdiagnosed, patients benefit from starting with a specialist who can:

• Distinguish vascular from non-vascular causes
• Manage both the clot and the long-term vascular consequences
• Coordinate care across hematology, surgery, cardiology, oncology, and primary care
• Provide non-surgical solutions whenever possible
• Follow patients over time to prevent recurrence and progression

There are the kinds of conditions that often fall between specialties — too vascular for rheumatology, too systemic for surgery, too structural for hematology, too nuanced for general medicine. Vascular medicine is the specialty that connects the dots and sees the entire picture — not just the blood, not just the anatomy, but the whole vascular system and the person living with it.

Vascular medicine is a small specialty with an enormous impact. I’m deeply passionate about helping patients find answers — especially when their symptoms have been dismissed, misdiagnosed, or misunderstood. Whether the issue is a common vascular condition or a rare, atypical disorder, my goal is always the same: to understand the whole vascular system, treat the root cause, and support long‑term vascular health.

If you’re experiencing unexplained vascular symptoms or want a comprehensive evaluation, CC Vascular Medicine is here to help.