About Us

about us



IN VEIN by Smalling Vascular Institute (SVI) was founded to focus solely on the treatment of Chronic Venous Insufficiency (CVI) while assessing the peripheral, or lower extremities or vascular disease, from a Cardiology perspective. There are only a handful of Interventional Cardiologists (IC's) in the US focused SOLELY on treating CVI outpatient and forgoing the typical  Cath Lab procedures. Dr. Ronnie Smalling saw an opportunity to ensure venous patients were not getting lost in the sea of Peripheral Arterial Disease and Coronary cases that make up a majority of an IC's day. IC's juggle a lot of patients and multitude of vascular disease, so Dr. Smalling set his sights on Venous Reflux patients to help fill a void for his fellow specialist colleagues.

We at SVI, built a 5,000 sq. foot premiere Vein Center in Overland Park, KS, dedicated foremost to treating venous insufficiency. And colleagues short of outpatient time, can consult Dr. Smalling to preliminarily help in diagnosing each patient's complete peripheral vascular system, if needed, prior to treating venous disease. IN VEIN was the brainchild of Dr. Ronnie Smalling, M.D., FACC, FSCAI, to help patients find solutions to issues and uncomfortable symptoms of the legs. IN VEIN opens in a time of a nationwide physician crisis, centrally located in the US, treating and diagnosing the underserved patients who suffer from unexplained leg pain and who are in need of treatment considering the 'whole patient leg approach'. Smalling and his veteran staff of highly skilled and experienced technicians, analyze, study and test leg pain and other symptoms, to find the culprit of the symptoms.  Some patients have crossover disease, so whether a patient's symptoms are venous or arterial in nature, Dr. Smalling can treat your venous insufficiency and he can address other vascular disease concerns, if applicable. Venous and arterial disease can both be subtle or similar and often, somewhat complex.

We specialize and treat venous patients here at IN VEIN with a customized approach. Each patient's needs are unique. And we work with our area's best Interventionalist's, to design a referral plan for patients with arterial concerns. Smalling knows Interventionalist's across the nation and here locally who specialize in Peripheral Arterial Disease (PAD) if your diagnosis requires that particular expertise. This is how Dr. Smalling became known as the Cardiologist's, Cardiologist.

We've built a deluxe center, with four stand-alone Operating Rooms to perform venous leg procedures. IN VEIN is outfitted with the most sophisticated technical advances to rid patients of varicose veins aches and pains and patients suffering from venous disease. We see young patients who stand long hours in a job. We see pregnant and post pregnant patients whose legs demonstrate the typical side effects of pregnancy of induced blood volume overload. We consult heavier weight patients of all ages. And we see older patients who suffer from diabetes, wounds that won't heal, among a few issues facing many patients. We use the best-regarded technologies to eradicate veins that are not working efficaciously. Every case, customized to each patient's disease and physiology, is the difference and key to our successes at Smalling Vascular Institute- IN VEIN.

One treatment technique will not always fit every patient. Therefore, we perform a variety of procedural technical approaches such as: Radio Frequency Ablation (RFA), Endovenous Laser Treatment (EVLT), Sclerotherapy, and or Micro-Phlebotomy where indicated. Options growing as technology advances, with Vena-Seal procedures to be offered in 2016. Vena-Seal, a proprietary medical non-thermal adhesive designed to improve venous destruction, often with less pain and fewer risks.* Many Vena-Seal procedures have the ability for Dr. Smalling to access the endovenous system, typically with a single access point of the venous system, lessening patient anxiety, reducing discomfort and in studies, have demonstrated less risks*.

What makes an Interventional Cardiologist?

Interventional cardiology is a highly specialized branch of cardiology that deals specifically with catheter-based treatments endovascularly. Guide wires pass through the arteries or veins. These catheters are used to study, repair, stent many structural issues within the heart and arteries throughout the body. IC's work on Coronary and Peripheral (legs) arteries in the Catheter Lab (Cath Lab) via use of dye to explore the arteries. Venous disease can be approached superficiously in an outpatient setting with ultrasound guidance. And more complex cases, are again, approached in the Cath Lab setting with catheters and dye. Most IC's have trained in a fellowship year for Cardiology. Followed by another additional fellowship year for Interventional Cardiology, which is the case with Dr. Smalling.

Dr. Smalling has spent his 24-year career using balloons, stents and other angioplasty tools to treat complex coronary arterial disease from the Interventionalist's perspective. Catheter skills are precision-based procedures most commonly utilized by Interventionalist's. Unlike the venous system, delicate and detailed are the smaller arteries requiring specialized technical skills, which are necessary for complex peripheral (legs) coronary and cardiac (heart) procedures. Renowned Interventional Cardiologist, Dr. Ronnie Smalling has brought his expertise with over 15,000 successful cases and experience to the Kansas City metropolitan area, where he longed for a private practice experience. Changes in healthcare and the use of technology has improved the outcomes in patients over the years. However, the demands in medicine have challenged the cardiologist's time. Sometimes changing the patient-physician face-to-face relationship. Concentrating on one targeted discipline, instead of the four or five mastered in his training, allows him and other physicians like him, to spend more face time with his/her patient. "I began missing the time to listen adequately to all the patient's health concerns and connecting them to their medical history and their chief symptoms", says Dr. Smalling. "Most patients have multiple medical issues, and the newer pressures of an institutionally structured practice, with set time limits, became a frustration. Time limits, or face-to-face time limits, don't work for me and for my patients. Even though I still have to be efficient with my clinic time, especially on procedure days, I can do what is best for each patient, each day. And I don't have anyone analyzing how long I spend with a particular patient. There are some symptoms or diagnostics that require more time spent with particular patients. Smalling Vascular Institute was my answer to my longing and my prayers. And the greater Kansa City area was and is, ideal."

(*- based on studies from Covidien/Medtronic's physician education materials provided.)

Our Team

Dr. Ronnie G. Smalling <br/><span>MD, FACC, FSCAI</span>

Dr. Ronnie G. Smalling

Dr. Ronnie G Smalling is a graduate of the University of Oklahoma College of Medicine in 1986 where he also completed his residency in 1989. His medical training continued when he accepted one of the four seats offered in the Cardiovascular Fellowship at LA County Hospital. There, Dr. Smalling trained under Clinical Instructor of Medicine at the University of Southern California Medical Center headed by professor Dr. Shahbudin Rahimtoola, who is the distinguished ACC recipient of a lifetime achievement award in 2013, in the company of only four other recipients ever to receive the ACC award. Dr. Rahimtoola known as "the world's cardiologist" and Dr. Smalling cites his successes over the past two decades has been tied to the physician who equipped him to excel in his expertise.

Dr. Smalling furthered his cardiology specialty by dedicating himself to an additional fellowship year specializing in Interventional Cardiology at The Heart Institute at St. Vincent Hospital in Portland, OR. Upon graduating, he moved his family of four to Springfield, MO and enjoyed a thriving Interventional Cardiology practice there for ten years. Besides his successes at St. John's Regional Health Center, he served as Medical Director for Hammons Heart Institute while also becoming known as a "Top Doc" in Cardiovascular Disease by "417 Magazine." Smalling was the author for several clinical Interventional Cardiology research trials and while developing patented devices and leading many educational speaking engagements. His patient successes led to Mercy St. John's recruiting Dr. Smalling to implement a Peripheral Interventional Cardiology for the Cardiology program in Joplin, MO in 2007. He built a thriving practice there and implemented the program to help support local patients from having to travel for their peripheral interventional needs. Along with implementing numerous new technologies to improve patient outcomes at Mercy St. John's.

Dr. Smalling was the attending cardiologist on the day of the Joplin tornado in May of 2011, which devastated the hospital and town. With his quick, decisive leadership, he led a team of ICU staff to prepare for impact within a few minutes after citing the tornado. He and the staff and tremendously compromised patients on the floors survived the wrath and all the patients, but one survived. He was one of the physicians called upon to meet with the media and emergency organizations. Despite losing the hospital, Dr. Smalling continued his successes in Joplin, posttornado, whether in 'office' trailers or temporary Cath Lab spaces where ever Mercy could secure one properly.

He was recruited again, to nearby Via Christi Pittsburg to implement a peripheral interventional cardiology program. He chose the area so he could stay close in proximity to his four children at home in Springfield, MO, but he felt he needed to select finally one facet of expertise in his vast endovascular skill set after being approached to fill a gap that was evident in Kansas City. With the encouragement of many colleagues with whom he has worked alongside developing industry leading peripheral devices and his involvement in current clinical studies and outcome data, he agreed that Kansas City would be the final city to implement an interventional cardiology practice, but solely dedicated to veins. IN VEIN of Smalling, Vascular Institute is to be his last private practice move and his most anticipated practice to date. After twenty-three years of helping his colleagues and hospital employers expand their interventional cardiology programs, Dr. Smalling is opening his state-of-the-art clinic in Overland Park, KS, while also bringing advances in treating chronic venous insufficiency to the greater Kansas City region. Dr. Smalling feels blessed to like his busy, long, distinguished career continuing today, with over 15,000 vascular procedures behind him, superior outcome rates that have been integral facilitating many very ill patients vascular improvements. The past years, Dr. Smalling has dedicated the majority of his practice working with Podiatrists and Wound Physicians to help patients with sore covered limbs, ulcerated gangrene limbs and complete or nearly complete salvaging limbs by his revascularization methods. Wound healing and dying tissue regeneration, where amputation was once the patient's only hope to save a diseased limb, he has been able to restore blood supply successfully to over 99.9% of the limb salvage patients with whom he has managed. Many who came to him with no hope of saving their legs. Limb health restoration and salvage are passions for Dr. Smalling's.

Dr. Smalling's decades of performing successful, extremely complex cardiac and peripheral procedures via endovascular techniques has Smalling pegged as the Cardiologist's venous referral specialist. Venous Disease, affecting between 60-80 Million people in the US has driven a need for the top technicians managing what was only considered a cosmetic procedure in the past. Vascular specialists are what other specialists recommend for their patients seeking relief from varicose veins and the side effects of Chronic Venous Insufficiency. Amazingly, Smalling wants to educate those involved in venous disease that many patients have early onset signs of venous disease, but wait until they're obvious on the surface of the skin. He seeks to educate better the population about typical symptoms that can sometimes trump noticing the ineffective veins on the surface. Experience and teaching are where Smalling's vast skill set will set him apart as a specialist, especially among the most complex and late-stage cases in the vein removal medical field. And why so many of his cardiology colleagues encouraged him to create Smalling Vascular Institute and opening IN VEIN in Overland Park, KS. Many interventional cardiologists struggle to find the time to dedicate the necessary scheduling time for vein removal while juggling other Cath Lab procedures. To fill this need is why Dr. Smalling is concentrating his private practice on veins 100% of the time at IN VEIN. He is THE referral source for other busy KC cardiologists. And he is the referral source for other specialists in the area seeking reputable and qualified interventional cardiologists to help their patients with CVI. The need in KC led Dr. Smalling to heed his colleagues requests for him to consider relocation and bring his skill set and years of expertise in peripheral vascular disease with hundreds of limb salvaging successes to the metro area. He is a premiere limb vascular health management specialist with a modern, professional clinic and staff. His practice makes him the only Interventional Cardiologist in a solo private practice solely dedicated to the art and skill of ridding patients of the troubling side effects of lower extremity inefficient venous systems and CVI. He's waiting to meet with you and to hear your concerns!

You can download a copy of his CV Here.

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Christopher Monse

- Coming from KU ER and with 7-years of clinical experience. Christopher is a right-hand to Dr. Smalling on day-to-day coordination of paitent care and referral coordination. Among many other responsibilities. Christopher is an integral piece in ensuring we at Smalling Vascular are the most patient-driven medical practice in the area.

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Mary Woods

Mary Woods is well-known in the CVI and Vascular medical community. Her life's work has provided Mary the widest scope of the anatomy and physiology of Venous Insufficiency equipping her to find and map peripheral disease. A vascular Interventionalist requires the assistance of an experienced and talented sonographer. And Mary Woods is the experienced asset any Interventionalist would partner with in venous disease treatment.

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