Vascular information from Dr. Bunke

Vein & Vascular News, Tips, Treatments and More!

La Jolla Vein & Vascular treatments for varicoceles

La Jolla Vein and Vascular Treatments for Varicoceles 

In most cases, varicoceles treatment is not necessary. Most men with varicoceles do not experience fertility issues. However, if the condition is causing pain, testicular atrophy, or infertility, you can benefit from varicoceles treatment. The treatment helps in sealing off the affected vein and redirecting the blood flow into normal veins. In case of infertility issues, varicoceles treatment helps in improving the quality of the sperm and sperm count. The procedure that we perform at LA Jolla Vein & Vascular on varicocele is percutaneous embolization of varicocele embolization.

The primary goal for varicocele treatment procedures is to help prevent the backflow of blood from the body to the scrotum, helping in cooling off the testes. Surgical procedures will help restrict the blood flow to the veins leading from the testis to the body. However, not all the veins are sealed off. The vassal vein, which is not subject to the same problems as the other varicose veins, is left open to allow blood to leave the testicles after the procedure.

Some of the clear indications that you need varicoceles repair during adolescence include pain, progressive testicular atrophy, and abnormal semen analysis results. While this treatment helps in improving sperm characteristics, it is not clear whether untreated varicoceles can lead to progressive sperm worsening. The common varicoceles treatment options include (La Jolla Vein & Vascular Only Performs Varicocele Embolization):

Percutaneous Embolization (Varicocele Embolization)

Percutaneous embolism is an advanced procedure performed by a radiologist. The specialist usually makes a small cut into a vein in the groin and inserts a tube. The doctor will use X-ray imaging to guide them to the affected veins and insert a coil or a balloon into it through the tube. The procedure helps in blocking the blood flow to the varicocele, shrinking it gradually. This procedure is also done with general anesthesia. 

Catheter-directed Embolization

Catheter-directed embolization is a non-surgical, outpatient treatment performed by an interventional radiologist using imaging to guide catheters or other instruments inside the body. Through mild IV sedation and local anesthesia, patients are relaxed and pain-free during the approximately two-hour procedure. 

For the procedure, an interventional radiologist makes a tiny nick in the skin at the groin using local anesthesia, through which a thin catheter (much like a piece of spaghetti) is passed into the femoral vein directly to the testicular vein. The physician then injects contrast dye to provide direct visualization of the veins so he/she can map out exactly where the problem is and where to embolize or block the vein, which reduces pressure on the varicocele. By embolizing the vein, blood flow is redirected to other healthy pathways. Essentially, the incompetent vein is shut off internally by preventing blood flow, accomplishing what the urologist does without surgery. 

Efficacy of Embolization for Varicoceles 

Embolization is equally effective in improving male infertility and costs about the same as surgical ligation. Pregnancy rates and recurrence rates are comparable to those following surgical varicocelectomy. In one study, sixty percent conceived were treated for infertility. 

In another study, sperm concentration improved in 83 percent of patients undergoing embolization compared to 63 percent of those surgically ligated. Patients who underwent both procedures expressed a strong preference for embolization. 

Varicocelectomy

Your doctor will make a small 1-inch incision into your scrotum and use a microscope or magnifying glass to see the veins better. The doctor might use local anesthesia to numb the area. General anesthesia can also help you sleep through the procedure.

Laparoscopic Surgery

This procedure involves making a much smaller incision and inserting a tube that holds the surgical tools. The surgeon will also use a special camera to see inside you. The procedure is done under general anesthesia to help you sleep through the procedure. The results from the other treatments are similar, only that the incision is small with laparoscopic surgery.

Open Surgery

The open surgery treatment is usually done on an outpatient basis and using a local or general anesthetic. The surgeon will make a small incision below your groin or abdomen to access the affected vein. Your doctor uses advanced surgical tools such as Doppler ultrasound and a surgical microscope to help guide the procedure. The patient can return to a regular daily routine after two days.

Recovery

In most cases, you can go back to your routine after two days of varicose treatment. However, it is advisable to take it easy. Avoid strenuous activities and exercise for about two weeks.

People who have undergone percutaneous embolization tend to recover faster. While you may need a day or two off from work, you can return to your workout program in 7-10 days. If the treatment procedure is to help with fertility, your doctor will perform an additional test in 3-4 months. You will be able to see improved results in 6-12 months. It is important to note that more than 50 percent of men who have undergone the procedure have restored their fertility. Additionally, these surgical procedures are also crucial for teens as they help in slowing testicular growth.

 

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

 

Our accredited center is also a nationally known teaching site and center of excellence. 

 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 


La Jolla Vein & Vascular treatments for varicoceles2022-10-24T12:20:15-07:00

Uterine Artery Embolization (UFE) vs. Hysterectomy

Benefits of UFE Over Hysterectomy

UFE is a minimally invasive procedure that is effective for treating uterine fibroids and is considered an alternative to uterine fibroid surgery removal. UFE is typically performed as an outpatient procedure, which means that most women go home the same day for recovery.

UFE has several benefits over hysterectomy. Besides involving only a small nick in the groin or wrist for catheter insertion, the uterus is preserved. There is no scar with UFE. For a UFE, conscious sedation is used, unlike for a hysterectomy, where the woman receives general anesthesia. The recovery time for UFE is generally within 2 weeks, which is significantly faster than the usual 6-week recovery time after hysterectomy.

Women who have a hysterectomy that remove both the uterus and ovaries usually just get estrogen replacement therapy (ERT) alone. But women who have only the ovaries removed need both estrogen and progestin because estrogen alone can increase the risk of cancer in the uterus.

The recovery time for UFE is generally within 2 weeks, which is significantly faster than the usual 6-week recovery time after hysterectomy.

The idea of having your entire uterus removed is psychologically daunting for women as some women may still want the option to carry a child, do not want to undergo a general surgery and/or feel like removing the uterus takes away part of their identity as a female.

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

 

Our accredited center is also a nationally known teaching site and center of excellence. 

 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

 

Uterine Artery Embolization (UFE) vs. Hysterectomy2022-10-24T15:33:14-07:00

Diagnosis of Varicoceles

Varicocele Diagnosis

Your doctor will perform a thorough physical examination, which might reveal a non-tender mass above the testicles to diagnose varicoceles. When the mass is large enough, it feels like a bag of worms. When the varicocele is small, the doctor might request you to stand, take a deep breath and hold it while you bear down. This technique will help the doctor to detect any abnormal veins enlargement. Your doctor may also order a scrotal ultrasound. The test uses high-frequency sound waves to create a precise image of the structure of the scrotum. The test is also helpful in helping the doctor rule out other reasons that could be causing the problem in the scrotum.

Treatments for Varicocele

 In most cases, varicoceles treatment is not necessary. Most men with varicoceles do not    experience   fertility issues. However, if the condition is causing pain, testicular atrophy, or infertility, you can benefit.

In most cases, varicoceles treatment is not necessary. Most men with varicoceles do not experience fertility issues. However, if the condition is causing pain, testicular atrophy, or infertility, you can benefit from varicoceles treatment. The treatment helps in sealing off the affected vein and redirecting the blood flow into normal veins. In case of infertility issues, varicoceles treatment helps in improving the quality of the sperm and sperm count. The procedure that we perform at LA Jolla Vein & Vascular on varicocele is percutaneous embolization of varicocele embolization.

The primary goal for treatment procedures is to help prevent the backflow of blood from the body to the scrotum, helping in cooling off the testes. Surgical procedures will help restrict the blood flow to the veins leading from the testis to the body. However, not all the veins are sealed off. The vassal vein, which is not subject to the same problems as the other varicose veins, is left open to allow blood to leave the testicles after the procedure.

Some of the clear indications that you need varicoceles repair during adolescence include pain, progressive testicular atrophy, and abnormal semen analysis results. While this treatment helps in improving sperm characteristics, it is not clear whether untreated varicoceles can lead to progressive sperm worsening. 

The common varicoceles treatment options include (La Jolla Vein & Vascular Only Performs Varicocele Embolization):

Percutaneous Embolization (Varicocele Embolization)

    Varicocelectomy

    Laparoscopic Surgery

    Open Surgery

     

 Recovery

In most cases, you can go back to your routine after two days of varicose treatment. However, it is advisable to take it easy. Avoid strenuous activities and exercise for about two weeks.People who have undergone percutaneous embolization tend to recover faster. While you may need a day or two off from work, you can return to your workout program in 7-10 days. If the treatment procedure is to help with fertility, your doctor will perform an additional test in 3-4 months. You will be able to see improved results in 6-12 months. It is important to note that more than 50 percent of men who have undergone the procedure have restored their fertility. Additionally, these surgical procedures are also crucial for teens as they help in slowing testicular growth.

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

 

Our accredited center is also a nationally known teaching site and center of excellence. 

 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

 

Diagnosis of Varicoceles2022-10-24T12:14:36-07:00

Complications of varicoceles

What are Varicoceles?

Varicoceles is a term used to describe abnormal enlargement of the veins within the scrotum. The veins carry blood from the various body organs back to the heart. Typically, veins have valves that prevent blood backflow. When the valves in the veins within the scrotum don’t work as they should, blood tends to collect in the scrotum, leading to varicoceles.

While varicocele is very common, it is not life-threatening. In fact, research shows that about 15 percent of all adult men have varicocele. For most men, the condition will go unnoticed throughout their life or does not cause any complications. Although the condition is not dangerous, varicocele is a common cause of low sperm production and reduced sperm quality, leading to infertility. Varicoceles can also lead to reduced testosterone production and scrotal discomfort. The condition often does not need treatment until there is a reason for concern about the associated problems. Fortunately, varicocele is easy to diagnose and treat.

Complications and Causes of Varicoceles

Unfortunately, although the condition is not life-threatening, it can also lead to several unpleasant complications.

  • Atrophy (shrinking of the affected testicles)

The testicles are made of sperm-producing tubules. Varicoceles damage these tubules, making the testicles soften and shrink.

  • Infertility

The condition also causes the local temperature around or in the testicles to be too high, affecting sperm formation

Causes

Medical practitioners are not sure of the leading cause of varicoceles. However, doctors agree that the condition forms when there is a problem with blood flow in the spermatic cord. The problem develops when the valves in the veins do not function properly and allows blood to flow back. As a result, blood pools in the veins causing them to dilate. When the condition is common in adults, it can also develop in teens during puberty. The testicles usually require more blood than usual during this growth cycle. This condition can lead to problems in the veins, preventing the blood from flowing where it should.

 

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

 

Our accredited center is also a nationally known teaching site and center of excellence. 

 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

 

Complications of varicoceles2022-10-24T12:12:11-07:00

What is Uterine Fibroid Embolization (UFE)?

What is Uterine Fibroid Embolization (UFE)?

With modern medication and care, conditions like fibroid tumors have become more treatable and easier to manage. Uterine Fibroid Embolization (UFE), for instance, is a fairly straightforward procedure used in the treatment of fibroid tumors in the uterus.

Sometimes referred to as uterine artery embolization (UAE), the uterine fibroid embolization (UFE) procedure helps countless women plagued by fibroid tumors.

What does the uterine fibroid embolization treatment entail, and how can you prepare for the procedure? Here’s everything you need to know about uterine fibroids treatment.

What is Uterine Fibroid Embolization?

The muscular walls of the uterus can sometimes be invaded by non-cancerous fibroid tumors. These tumors are also known as myomas and are a form of benign tumors. While these fibroid tumors rarely become cancerous, they can lead to other severe conditions such as increased menstrual bleeding, bowel or bladder pressure, and pelvic discomfort. 

Admittedly, while uterine fibroid embolization shows a high success rate, more research is still needed on the subject. For instance, at the moment, the procedure is usually performed on women who no longer desire to get pregnant. The UFE procedure may also be used on women who wish to avoid a hysterectomy procedure. 

When is Uterine Fibroid Embolization Used? 

 

As mentioned above, uterine fibroid treatment is rather straightforward and minimally invasive. As a result, the procedure can be used in a wide variety of cases. Some of the instances where the treatment is necessary or advocated for include;

  • Malignant gynecological tumors
  • Hemorrhage after childbirth
  • General or specific trauma

 

How to Prepare for a Uterine Fibroid Embolization Procedure

 

The healthcare professional will first need to ascertain if the fibroid tumors are the underlying cause of any visible and diagnosable symptoms. Afterward, they’ll need to determine the size, location, and the number of fibroids. This can be done with the help of an ultrasound machine or magnetic resonance imaging (MRI) equipment.

Moreover, your gynecologist may also need to run a physical examination through a laparoscopy examination. This test gives a clearer picture of the uterus and the invasive fibroids. You could also have a biopsy of the inner lining of the uterus if you are bleeding excessively in between your periods. The procedure known as endometrium helps rule out cancer as the cause of bleeding.

If you are on any medication, supplements, or herbal remedies, you’ll need to inform the doctor before the procedure. Additionally, make a list of any known allergies, including general and local anesthesia and the dye or contrast materials.

It’s also wise to notify the healthcare team if you have recently suffered an illness, just finished treatment, or are on other medication. For example, if you’re on blood thinners, the healthcare provider may advise you temporarily halt the medication in preparation for the procedure.

Women who suspect they are pregnant should let the doctor know well before the uterine fibroid embolization treatment. Some imaging tests are usually not performed during pregnancy in a bid to minimize any radiation exposure to the fetus. In the case of an imaging test, such as an x-ray, which is essential to the operation, particular care guidelines must be followed to manage and reduce radiation exposure.

While preparing for the procedure, you’ll likely be put off solid meals after midnight to the procedure’s day. While the procedure takes a few hours, the doctor could request to stay overnight for further observation.

 

What Equipment to Expect

 

Since this is a minimally invasive procedure, the tools and equipment used are reasonably common and risk-free. Some of the equipment to be used in uterine fibroid embolization treatment includes a catheter, x-ray machines, and various embolic agents and medications.

The synthetic material used is known as embolic agents and varies in composition and efficacy. The three most common types of embolic agents are;

-Gelfoam whose texture resembles spongy material

-Polyvinyl alcohol, which resembles coarse sand

-Microspheres, which is a polyacrylamide sphere coated with gelatin

These tolls, equipment, and medication are all safe to use during the uterine fibroid embolization treatment.

 

Benefits and Risks Associated with Uterine Embolization Treatment

 

Some of the advantages of uterine fibroid embolization include;

-There’s no need for surgery as the procedure is minimally invasive

-You can resume regular activity sooner and faster

-The procedure is highly effective, boasting well over 90% efficacy rating

-Fibroids rarely regrow after the uterine embolization treatment

-On the other hand, some of the risks that could occur during the procedure are;

-The procedure pierces the skin and could leave an infection if not properly cleaned

-The embolic agents need to be guided carefully, or they could lodge in the wrong area

-Fibroids can lead to chronic pain and an array of other conditions. With uterine embolization treatment, you can now get relief and get back to your healthy self.

 

What To Expect during Uterine Fibroid Embolization Procedure

 

A UFE usually takes between 1 and 3 hours and patients usually require about 6 hours of bed rest after the procedure. Patients may experience mild discomfort as the embolization takes full effect. The fibroid tumors breaking down and exiting the body may cause light bleeding for the few weeks after the procedure. Most patients can expect to return to normal activity 7 to 10 days after the procedure. Our physicians will most likely recommend a follow-up consultation after the UFE 1 to 3 weeks afterward and an ultrasound or MRI 3 to 6 months later to monitor your progress.



La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

 

Our accredited center is also a nationally known teaching site and center of excellence. 

 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 


What is Uterine Fibroid Embolization (UFE)?2022-10-24T15:28:45-07:00

Causes of non healing ulcers and wounds

Non-healing ulcers & wounds do not follow the usual healing process and are referred to as chronic wounds should they persist beyond 3 weeks. Such wounds can be a heavy burden to live with for anyone. Still, the board-certified vascular surgeons and specialists at La Jolla Vein & Vascular are dedicated to administering effective treatment and management solutions to all patients so they may resume a healthy, productive, and pain-free life.

Types of Non-Healing Ulcers

In general, patients will present with one of three categories of non healing ulcers & wounds, with these categories being broadly defined by the major causative factors allowing for their development. These are:

Arterial or Venous Ulcers

These are found to account for between 70% up to 90% of non-healing wounds or non-healing ulcers. Mostly occurring in elderly patients, they are believed to come about as a result of a failure of the valves in a person’s blood vessels of both arteries and veins. These valves are responsible for preventing the backflow of blood as it passes within them. The consequent outcome is a lack of nutrient and oxygen-rich blood from reaching the affected tissues and sets up the conditions favoring non-healing wounds.

Pressure Ulcers

These are ulcers that are brought about by the restriction of blood flow to certain regions of the body due to the persistent and prolonged application of pressure upon them. It is mostly encountered among patients with full or partial paralysis and those who are bedridden for extended periods.

Diabetic Ulcers

These are also highly prevalent chronic wounds, and are on the increase among patients owing to the ever-increasing cases of diabetes among the population. In fact, the prevalence of chronic wounds among diabetics makes this demographic 15% more likely to have to undergo limb amputation as a complication of the condition.

The causes of non healing ulcers & wounds: 

The underlying factors contributing to the risk of developing a non-healing ulcer or wound are widely varied. What they have in common is their ability to interfere with the way the body normally functions with regard to wounds.

Nerve Damage (Neuropathy)

Circulatory System Issues

Underlying Health Conditions

Nerve Damage (Neuropathy)

Non healing ulcers & wounds are prevalent in people living with certain circulatory ailments such as atherosclerosis, diabetes, alcoholism, etc. In a healthy person, the nerves will send signals to the brain whenever pain or discomfort is experienced in any body tissues. Neuropathy makes this system non-functional; tissue can be damaged without warning signals being sent to the brain. This will prompt the person to change position or remove the object, causing injury. Over time, the affected area might see the development of an ulcer.

Circulatory System Issues

A person’s circulatory system is responsible for delivering blood rich in oxygen and nutrients to all the tissues in the body that need it. Without it, tissues will begin to die. Due to their extremity (distance from the heart) and the effect of gravity, a person’s feet will often be the first problem area for a person with an impaired circulatory system. Peripheral artery disease (PAD) is a particularly culpable condition in this instance as it may lead to numbness, skin discoloration, severe pain, ulcers, or even the patient’s demise if left unchecked.

Underlying Health Conditions

The formation of non-healing ulcers will indicate that an advanced stage of certain conditions has been reached in a patient. These conditions include high blood pressure, diabetes, kidney failure, high cholesterol, or peripheral artery disease (PAD). These conditions contribute to the formation of ulcers by causing ischemia, or the interruption of oxygenated blood to all parts of the body, or by damaging the nerves in the wound areas.

Contributing Lifestyle Habits

Some various habits and lifestyles will place patients at a heightened risk of developing non-healing ulcers. Smoking, for instance, has the effect of narrowing the vessels carrying blood to body tissues, thus increasing one’s chances of developing ulcers. A sedentary lifestyle involving little to no active movement will also carry the risk of encouraging ulcer development due to the constant pressure applied to certain tissues. Old age is also a factor here, as our skins will gradually lose their ability to repair themselves as quickly and efficiently as they once did.

 

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

 

Our accredited center is also a nationally known teaching site and center of excellence. 

 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

 

Causes of non healing ulcers and wounds2022-10-24T12:05:07-07:00

Your height & varicose veins

Does height play a role in developing varicose veins? Yes. We initially presented this information in 2018, after a study at Stanford University School of Medicine found a person’s height to be a significant risk factor for developing varicose veins. “We not only found an association between height and varicose veins, but the genetic studies we did showed a causal link,” said cardiologist and study author Dr. Nicholas Leeper, an associate professor of surgery and cardiovascular medicine at Stanford. “That suggests that the genes and pathways that drive human height are also likely to be causing varicose veins.” The study originally published in 2018, found a significant link between above-average height and vein health. In this population-based study of ~500,00 individuals, greater height appeared as a novel predictor of varicose vein disease in machine learning analyses, and was independently associated in multivariable-adjusted Cox regression.

Other known influences such as age, excess weight, being female, and genetics also play a role in the development of them. This study reveals that taller individuals, the study concluded, have a greater chance of developing them and possibly even blood clots in the legs.

The reason has to do with gravity — blood from the legs of taller people must travel a greater distance to the heart, which forces the veins to work harder. But it also has to do with genetics. The study’s authors found above-average height was not only associated with varicose veins, but could be the underlying cause of the swollen veins that rise to the surface of the legs and feet as well.

Lifestyle modifications to reduce the risk of developing them by including use of compression stockings when traveling and sitting or standing for longer periods of time, exercise, weight loss (if indicated), and leg elevation. Read about measures to reduce symptoms related to varicose veins.

Original Study Published in Circulation.

Clinical and Genetic Determinants of Varicose Veins: A Prospective, Community-Based Study of ~500,000 IndividualsEri Fukaya, Alyssa M. Flores, Daniel Lindholm, Stefan Gustafsson, Daniela Zanetti, Erik Ingelsson, Nicholas J. LeeperCirculation.

 La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

 

Our accredited center is also a nationally known teaching site and center of excellence. 

 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

 

Your height & varicose veins2022-10-24T11:41:31-07:00

What is vascular disease?

What is Vascular Disease? 

Your body contains an amazing, intricate system of arteries and veins that can contribute to vascular disease if the conditions are right. Arteries bring oxygen-rich blood from the heart to every inch of the body; veins return the blood back to the heart and lungs for more oxygen.

Most people know that heart disease can occur when blood vessels become clogged with plaque and cholesterol, but many are unaware that the same problem, often called hardening of the arteries (or atherosclerosis), can occur in any artery of the body.

Venous problems occur in the veins, often resulting in leg swelling, deep vein thrombosis (blood clots) and chronic leg problems.

Common types of artery disease include:

Carotid artery disease and stroke

Carotid arteries in the neck bring oxygen to the brain. Patients who have had a stroke, a transient ischemic attack

(TIA) or have been told they have an abnormal sound in that artery, will be referred to a vascular surgeon for diagnosis and possible treatment.

Aneurysms

Aneurysms are bulges that develop in a weakened part of an artery. While these can occur in the brain, they are most common in the aorta, which is the body’s biggest artery, running from the heart through the abdomen. Aneurysms can also occur in the pelvis or the knee. They can enlarge when the heartbeat pushes against the weakened wall. In the aorta and pelvis, ruptured aortas can be fatal.

Peripheral arterial disease (PAD)

Patients with hardening of the arteries start to lose blood flow to the limbs. Early on, this may cause pain when walking, but as the disease progresses, it can cause painful foot ulcers, infections, and even gangrene, which could require amputation. People with PAD are three times more likely to die of heart attacks or strokes than those without PAD.

Common Vascular Disease Problems: 

  • Varicose veins which are often cosmetic, but can also be a sign of a more serious venous disease.
  • Chronic venous insufficiency is a potentially painful condition that is caused by blood reflux or clotting.
  • Deep vein thrombosis a blood clot in a deep leg vein.

Who are Vascular Surgeons:

Vascular surgeons train in vascular disease for five to seven years after medical school. Board certified vascular surgeons can treat any vascular condition with any treatment—medication, minimally invasive endovascular surgery, or open surgery. Many vascular conditions are lifelong, and your vascular surgeon may become a lifelong care partner. Be sure to ask to be referred to a board certified vascular surgeon.

 

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

What is vascular disease?2022-10-24T11:38:09-07:00

What you need to know about venous insufficiency

When you become a patient with La Jolla Vein and Vascular, you will go through a screening process, and a vascular evaluation using ultrasound technology to diagnose your venous reflux disease. Chronic venous insufficiency is a disease affecting at least 50 million Americans. It is very common, but unfortunately undiagnosed. Through our venous insufficiency Duplex Ultrasound test, our vein specialists can determine exactly what is going on in the patient’s veins. 

The anatomy and process of venous insufficiency or venous reflux disease: 

One of the major veins that takes the blood to the heart is deep inside the muscles of the thigh and calf called the deep veins. Parallel to this lies the superficial veins inside the legs. Superficial veins dump the blood into the deep vein in the groin area and collectively they take the blood back to the heart. 

The direction of the blood flow begins from the ground up towards the heart. Both deep and superficial have a structure system known as the valves. They function as a safety unit directional valve system. Where the blood can flow upward and not downward and be open or closed off. Similarly the same type of structure is found in your heart with heart valves. 

Over the course of the years, depending on your occupation, family history, pregnancy, surgeries, any trauma or injury to your legs, and any kind of underlying muscular or skeletal problem will contribute to problems with the valves in your legs. The valves, over the course of the years may get farther apart from one another. They will still be able to open and close, but the main problem will be the blood flow will not be able to go in one direction. This causes the veins to become enlarged. As a result,  the valves remain open and the blood to flow upward and also downward. This is known as venous reflux disease or venous insufficiency. 

A consultation with one of our vein specialists for chronic venous insufficiency involves taking a detailed history and physical examination in combination with a venous reflux ultrasound study.  Based on your personal findings, a customized treatment plan will be discussed which may include doing nothing, conservative management, or various treatment options based on your individual needs. 

 

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

 

Our accredited center is also a nationally known teaching site and center of excellence. 

 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

 

What you need to know about venous insufficiency2022-10-24T11:36:50-07:00

What you need to know about abdominal aortic aneurysm

What is an abdominal aortic aneurysm (AAA)?

The aorta, the largest artery in your body, runs from your heart, down through your chest, and into your abdomen. The abdominal region of the aorta is responsible for delivering blood to your legs, GI tract and kidneys.

An abdominal aortic aneurysm (AAA) occurs when the wall of the aorta progressively weakens and begins to bulge. An AAA may continue to enlarge and eventually rupture if left untreated, causing severe internal bleeding and possibly death. Nearly 200,000 people in the United States are diagnosed with A A A annually; approximately 15,000 die each year from a ruptured AAA.

In addition to concerns about rupture, clots or debris may also develop within an AAA. These substances can be carried to other areas in the body and block circulation, causing severe pain or possibly limb loss if blood flow is cut off for too long.

AAA can be safely treated with early diagnosis; however, most patients have no symptoms.

Causes and Risk Factors:

Most aortic aneurysms are caused by a breakdown in the proteins that provide structural strength to the wall of the aorta. Some risk factors that contribute to this structural breakdown include:

  • Age—individuals over 60 years are most likely to develop the condition
  • Gender—males are more prone to the condition than females
  • History of atherosclerosis (hardening of the arteries) • Family history of AAA
  • Smoking
  • High blood pressure

Symptoms:

Most people feel no symptoms, and an abdominal aortic aneurysm is often detected when tests are conducted for other unrelated reasons. Those who do have symptoms commonly describe back pain, pulsations in the abdomen, groin pain or sometimes sores on the feet.

Diagnosis

If an abdominal aortic aneurysm is suspected, you likely will be referred for an abdominal ultrasound, a painless, safe test that can screen for and measure the size of an AAA. Computed tomographic angiography (CTA) can assess aneurysm size, location and the extent of impact. This study requires exposure to radiation and injection of an intravenous contrast agent. However, a CTA provides valuable anatomic information and can help your vascular surgeon determine the optimal type of repair.

Medicare Screening Benefit

Medicare offers a free, one-time AAA ultrasound screening for qualified seniors as part of their Welcome to Medicare physical during the first 12 months of their enrollment. Men who have smoked sometime during their life and men and women with a family history of AAA are eligible for this benefit.

Treatment

Vascular surgeons can determine the best procedure for you, based on the size of your aneurysm and other factors. For smaller AAAs, you may need to make lifestyle changes, such as quitting smoking and lowering blood pressure. You may be prescribed medication. Your surgeon will have you come back for regular checkups to see if the AAA has changed.

For large AAAs, or those that have been increasing in size over time, repair may be carried out either by placement of an endovascular stent graft or by open bypass grafting.

Be sure to see a board certified vascular surgeon. They have specific training in both minimally invasive and traditional open repairs. The type of repair conducted is very important to long term durability and freedom from rupture.

La Jolla Vein & Vascular runs  the diagnostic ultrasound for AAA, but will refer out for treatment.

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

What you need to know about abdominal aortic aneurysm2022-10-24T14:50:55-07:00
Go to Top