Welcome to Big Sky Vascular

We Treat the Cause of Vein Disease, Not Just the Symptoms

With more than 18 years of experience, Dr. Giuliano and her team focus on providing you with the expert care you need and deserve. We don’t just alleviate your symptoms in the short-term. At Big Sky Vascular, we’re dedicated to treating the underlying cause of your vein disease, not just the symptoms. Our team will work closely with you to fully understand your problems and accurately identify the true cause of your vein disease.We take the time to help you understand the best vein treatments and lifestyle changes you can make so you can get back to looking and feeling healthy in the long-run.

What is Vein Disease?

Varicose veins are common and can be found in up to 25% of women and 15% of men.They can be many different sizes, from bulging veins under the skin to very small ‘ spider ’ veins at the skin surface. Varicose veins occur when the blood doesn’t efficiently exit the leg. In normal circumstances one-way valves in the veins prevent blood from falling backwards in the leg. If the valves don’t work well the blood leaks backwards in the vein, the venous pressure increases, and the veins can swell and cause symptoms of leg discomfort.

The veins in your body play an important role in circulation, carrying blood from your various parts of your body back to your heart. Yet, as people age, problems can develop in the veins and cause a variety of complications. In fact, 1 in 3 Americans over the age of 45 has some kind of vein disease.

Early symptoms may seem minor. However, they can become more serious – and even life-threatening – if they are not treated. Which is why it is important to be aware of symptoms and seek medical advice at the earliest sign of a problem. We have listed some very common symptoms that people may experience.


  • Aching pain
  • Easily tired legs
  • Leg heaviness
  • Swelling in the legs
  • Darkening of the skin (in severe cases)
  • Numbness in the legs
  • Itchiness around vein areas
  • Large ropey veins
  • Restless legs
  • Sores or wounds that won’t heal



There are several procedures that can be used alone or in combination to treat varicose veins. These include:

  • Sclerotherapy, in which a doctor injects the veins with a solution that causes the vein to close and the blood is then directed through healthier veins.This is a common treatment option, but may require multiple treatments. It is useful for treating small and medium sized varicose veins.

  • Endovenous thermal ablation, in which a thin tube (catheter) is inserted into the vein. Then, the physician applies heat through the tube, causing the vein to collapse. A scar results and the blood is forced through nearby healthy veins. This procedure is also used to treat larger varicose veins.

  • Ambulatory phlebectomy, in which the doctor removes larger varicose veins in the legs through a series of tiny skin punctures (holes). Local anesthesia is used. There is usually little scarring.