Vascular information from Dr. Bunke

Vein & Vascular News, Tips, Treatments and More!

How can smoking affect your vascular health?

Smoking and Vascular Disease
The reality of cigarettes is that it is not one product. Every time you smoke, you not only ingest nicotine, but hundreds of other deadly chemicals in the tobacco leaf, paper, contaminants and fertilizers used to grow tobacco. Over time the accumulation of these products causes serious harm to multiple organs. And unlike many things in life, moderation in smoking is not a cure.
Benzene, for example, is a substance on the Environmental Protection Agency’s list of national hazards. It is abundant in tobacco smoke and takes more than 32 hours to completely clear the human body. That means that even ONE cigarette a day continues to keep this poison in your system.
What does smoking do to your arteries?
Smoking is the number one preventable cause of death in the United States. Its effect on heart attacks, peripheral vascular disease and strokes is due to the damage that smoking does to the arteries.
The two chemicals in cigarettes that cause the most trouble are nicotine and carbon monoxide. Nicotine, besides being addictive, has very powerful effects on arteries throughout the body. Nicotine is a stimulant, speeding up the heart by about 20 beats per minute with every cigarette. It raises blood pressure and is a vasoconstrictor, which means it makes arteries all over the body become smaller. That makes it harder for the heart to pump blood through the constricted arteries and it causes the body to release its stores of fat and cholesterol into the blood.
Smoking accelerates the hardening and narrowing process in your arteries; it starts earlier and blood clots are two to four times more likely. Smoking lowers your levels of high-density lipoprotein cholesterol and raises your levels of low-density lipoprotein cholesterol. It decreases the movement of cholesterol through the body, and contributes to its accumulation in your arteries. This puts you at a higher risk for heart attack, stroke, and limb loss.
Your vascular health
Cigarette smoking increases risks of blood clots significantly. If the blood clots in an artery and blood can no longer get through, the tissue that is supposed to be supplied with blood has lost the source of its oxygen and nutrients and dies in minutes. This can result in heart attacks, strokes, and gangrene of the leg.

Smoking effects on the brain:
Smoking increases the risk of stroke by narrowing the arteries in the brain and the carotid arteries in the neck that lead to the brain. In addition, the vessels to the brain can become blocked by a clog or blood clot, which can lead to collapse, stroke and paralysis. If the blood vessels are completely blocked to part of the brain, that part will die. Patients may lose the ability to speak, walk or move normally, or, depending on the part of the brain affected, the stroke may be fatal.

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

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.

How can smoking affect your vascular health?2022-09-19T15:46:28-07:00

Complications of Untreated Varicose Veins: Bleeding or Hemorrhage Caused by Vein Rupture

Untreated varicose veins are at a higher than usual risk of bleeding or spontaneous rupture.   Over time, varicose veins become larger, and the vein wall becomes weak and stretched out. These veins, which are already weak, are also under high pressure (because of venous reflux, or the ‘backflow’ and pooling of blood in these veins). As a result, the high pressure can cause the veins to spontaneously burst and bleed heavily. Because they are under high pressure, they bleed like an arterial bleed and patients describe the bleeding as ‘blood shooting across the room.’  

 

The varicose veins that are susceptible are veins closest to the surface of the skin.

Most patients describe that it occurs during or after a warm shower (warm water causes veins to relax and dilate, allowing more blood to pool within the veins) or during sleep. It is painless and patients report that they notice it because they feel something wet in bed.  Patients who are on blood thinners can lose large amounts of blood, especially if it occurs while they are sleeping. Some people have required blood transfusions. The small blue spider veins around the ankle are equally at risk of rupture as are the larger bulging veins.

 

This is a patient who experienced spontaneous hemorrhage of their varicose veins. Notice the appearance of the blue, bulging veins that we describe as, ‘blue blebs.’ These veins are dilated, weak, and are close to the surface of the skin. The pooling blood within these veins causes high pressure, ultimately resulting in a spontaneous rupture or hemorrhage. The bleeding is rapid since varicose veins are under high pressure.  This is a common condition that we see at La Jolla Vein Care.

 

If someone you know has experienced bleeding from their varicose veins, they should be seen by a doctor. Treatment will prevent the veins from bursting again. This is a common condition that we see at La Jolla Vein & Vascular.

 

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

 

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 Untreated Varicose Veins: Bleeding or Hemorrhage Caused by Vein Rupture2022-09-19T15:41:12-07:00

ClosureFast™ an endovenous radiofrequency ablation (RFA) procedure

ClosureFast™ an endovenous radiofrequency ablation (RFA) procedure

The procedure, Closurefast is for the backward flow of blood (or “Venous reflux”) in your saphenous vein(s). The great saphenous veins and small saphenous veins are the two main superficial veins of the leg. They run along the inner leg and the back of the leg, respectively. This minimally invasive procedure can be performed in the office in less than an hour and patients usually return to their usual level of activity the same day.

 

How does the treatment work?

During Closurefast, the skin is numbed with lidocaine, then a tiny wire and the Closurefast catheter are inserted into the vein. The catheter delivers radio-frequency energy to the vein wall, causing it to seal shut. The remaining healthy veins continue to bring blood back to the heart.

What should I expect on the day of treatment?

 

The procedure, Closurefast is performed with local anesthesia, but many patients elect to use a mild oral sedative (Valium), which is taken after checking in and completing all paperwork.  You will change into a gown and leave underwear on.  Depending on the vein to be treated, you will lay on your back or on your belly.  We do our best to make special accommodations (for example, if you cannot lie flat or cannot bend a knee very well) with body positioning and using pillows.  We will do our best to make you comfortable.  Then, we will give you the option of watching a movie on Netflix or listening to music.  Once you are comfortable, your leg (s) will be prepped with a cleansing solution for the sterile procedure.  The doctor will perform an ultrasound to map the vein (s) to be treated.  Then, a numbing agent (lidocaine) will be injected into the skin. In the numb area of the skin, a tiny puncture is made to pass the radiofrequency catheter.  Your doctor will then use a needle to administer a combination of cool saline and local anesthetic around the vein either in the thigh or calf (depending on which vein is treated).  This solution numbs the vein and insulates it from the surrounding tissue.  After the numbing solution is applied, the vein is painlessly treated with radiofrequency energy.

Once your vein has been treated, we will clean your leg and apply a compression stocking which you will wear for 72 hours continuously.  You will walk for 30 minutes prior to getting in your car.

Watch a live radio frequency ablation treatment at La Jolla Vein Care.

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

 

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. 


ClosureFast™ an endovenous radiofrequency ablation (RFA) procedure2022-09-19T15:33:58-07:00

3 Vein Treatments

Varicose Vein Treatments

Varicose veins, which are the bulging, twisted veins just beneath the surface of the skin, can be effectively treated after the underlying vein reflux is corrected. There are two main options for removing the varicose veins; either a foamed medication can be injected into the veins causing them to scar and eventually dissolve (foam sclerotherapy), or they can be removed using tiny incisions (phlebectomy).  Sometimes, a combination of both treatment types may be recommended as well as other options listed below. 

 

Venous Reflux Disease Treatments for underlying vein reflux:

 

The ClariVein® procedure

for treatment of backwards flow (or “reflux”) in your saphenous vein(s). The great and small saphenous veins are the two main superficial veins of the leg. They run along the inner leg and the back of the leg, respectively.

This minimally invasive procedure can be performed in the office in less than an hour and patients return to their usual level of activity the same day.

How does the treatment work?

The skin is numbed with lidocaine, then the ClariVein® catheter is placed into the unhealthy vein. The catheter closes the vein painlessly by delivering two treatments:

  1. Mechanical treatment with a tiny rotating wire.
  2. Chemical treatment with polidocanol. Polidocanol is a detergent-type sclerosant medication that is commonly used in varicose vein treatment.

This technique is highly effective in closing the vein and only requires one skin puncture, similar to placing an IV.

 

In the video linked here, Dr. Bunke discusses the ClariVein® procedure.  The other video shows how the treatment is done. We offer many other videos on our YouTube channel.   After care instructions can be found on our website under the patient resources tab.

 

ClosureFast an endovenous radiofrequency ablation (RFA) procedure

The procedure is for the backward flow of blood (or “Venous reflux”) in your saphenous vein(s). The great saphenous veins and small saphenous veins are the two main superficial veins of the leg. They run along the inner leg and the back of the leg, respectively. This minimally invasive procedure can be performed in the office in less than an hour and patients usually return to their usual level of activity the same day.

 

How does the treatment work?

The skin is numbed with lidocaine, then a tiny wire and the Closurefast® catheter are inserted into the vein. The catheter delivers radio-frequency energy to the vein wall, causing it to seal shut. The remaining healthy veins continue to bring blood back to the heart.

 

WHAT IS VARITHENA®?

 

Varithena® is a “microfoam” formulation of polidocanol (sclerosing agent) and CO2. The result is a microfoam that has an appearance and consistency similar to white, foamy shave cream. Ultrasound guidance is used to inject Varithena® microfoam into the vein. The microfoam fills the lumen for circumferential contact where it’s designed to displace blood and destroy the endothelial lining efficiently.

 

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

 

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. 


3 Vein Treatments2022-09-19T15:20:52-07:00

What you need to know about Varicoceles

What are Varicoceles?

A varicocele 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.

How do Varicoceles Affect the Testis?

While numerous theories exist, medical experts agree that varicoceles cause the veins to carry warm blood from the abdomen down to the testis. Generally, the testis functions properly at around three degrees below the average body temperature. As such, warmblood can affect the testis’ ability to produce testosterone and sperm.

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

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 and to book a consultation, please give our office a call at 858-550-0330. 

For more information 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 Varicoceles2022-08-18T17:08:55-07:00

Risk Factors of Developing Uterine Fibroids

Who is at Risk of Developing Uterine Fibroids?

There are certain natural circumstances, habits, and lifestyle choices that have been shown to come with an increased chance of developing uterine fibroids, as follow:

–Ethnic Origin

Research indicates that women of African American ethnicity are at a significantly higher risk of developing uterine fibroids than Caucasian women for comparison. 

–Age

A woman’s advancing age places her at increased risk of developing uterine fibroids. The condition will mostly be found in women in their mid-late forties or early fifties, where the majority enter or pass through their menopausal years. 

–Family History

Simple stated, this means that those with a history of uterine fibroids will be more likely to develop the condition. 

–Eating Habits

It is believed that the consumption of red meat (beef, ham, etc) in copious amounts will increase the risks of uterine fibroid development. The consumption of green vegetables, on the other hand, is thought to reduce these odds. 

–Obesity

Being overweight is considered to be another variable increasing women’s risk of developing this condition, with overweight patients being two to three times more likely to be affected than the average population. 

Treatment Options for Uterine Fibroids

The varied nature of uterine fibroid cases and how they affect different patients in different ways means that dealing with the condition has numerous different approaches. Consultations between patients, whether presenting with symptoms or not, and their physicians should be able to see them agree on a course of action that will satisfy the patient’s best interests. Aside from medication, the typical treatment for fibroids is traditional surgical procedures. At Pedes Orange County, we offer a minimally invasive treatment option that can be reviewed below:

Traditional Surgical Procedures

These are considered invasive surgeries that involve extensive physical intervention. They include:

  • An abdominal myomectomy is an option mostly employed in cases where very large, very deeply embedded, or multiple fibroids are encountered. An open abdominal procedure is often the second-to-last option for patients who see hysterectomies as a last resort.
  • Hysterectomy: This major surgical intervention involves the entire removal of the patient’s uterus and is the only guarantee against the recurrent development of uterine fibroids afterward. While most women will have the option of retaining their ovaries, some will have to undergo hormone replacement therapy if they are not to enter menopause.

Minimally Invasive Surgical Procedure (Uterine Fibroids Embolization by La Jolla Vein & Vascular)

At La Jolla Vein & Vascular, we specialize in Uterine Fibroids Embolization. This minimally invasive surgical procedure involves destroying fibroid masses without necessarily removing them entirely. The techniques are most commonly applied in clinical settings due to their effectiveness, proven track record, and minimal patient impact.

  • Uterine artery embolization: (Also known as Uterine fibroid embolization). Embolic agents (small particles) will be introduced into arteries to block blood flow through them, thus starving fibroids of the nutrients needed for their survival and growth.

In surgical procedures that do not entirely remove the uterus, there will be a remaining risk of new uterine fibroid development in the future.

Why Uterine Artery Embolization (UFE) Instead of a Hysterectomy

Benefits of UFE Over Hysterectomy

Uterine artery embolization (UFE ) is a minimally invasive procedure that effectively treats uterine fibroids and is considered an alternative to uterine fibroid surgery removal. Uterine artery embolization (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 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 removed both the uterus and ovaries usually 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.

Treatment for Uterine Fibroids

With modern medication and care, conditions like fibroid tumors have become more treatable and easier to manage. Uterine fibroid embolization, for instance, is a fairly straightforward procedure used in…

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

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 and to book a consultation, please give our office a call at 858-550-0330. 

For more information 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. 

Risk Factors of Developing Uterine Fibroids2022-08-18T16:57:50-07:00

The cause of Uterine Fibroids

What Causes Uterine Fibroids?

While the science is not completely settled on what exactly causes or is behind the formation of uterine fibroids in human beings, there are certain factors that researchers believe play significant roles in triggering their growth or development.

Genetics

In 50 percent of cases, patients will be found to have some genetic abnormality. In many instances, some erroneous translocation will be discovered on some chromosomes.

Hormones

While we may not be completely certain as to what lies at the root cause of uterine fibroids, it has been clearly demonstrated that hormones play a large role in determining their growth or progression. While a woman is pregnant, they will see rapid growth due to the presence of the hormones estrogen and progesterone. Should the patient use anti-hormone medication, the opposite will happen – the fibroids will shrink. Furthermore, fibroids will stop growing or begin shrinking once a patient reaches menopause, which is the point at which these hormones also cease being produced in the female body.

Testing and Diagnosis of Uterine Fibroids

In many cases, especially those whereby uterine fibroids do not present any noticeable symptoms for the patient, this condition will be discovered in a regular pelvic exam. This is a routine checkup carried out by gynecologists. While this checkup might determine the presence of a mass or lump on the uterus, further testing will have to be carried out to make a definite diagnosis.

These testing methods include:e09eQd4jBPpzFnkwnMj7SJxpMh25WCLWoP3loxbQ6e8AX7s1hnnTfHS56W7p 4P7RhhoJW2ZYHIvZJeIsOhXGMM9C CMIYZ3Fs7WPPuSENG3E

Note: Upon learning that fibroids are a type of tumor, the foremost concern for many patients is whether the tumor is cancerous or might predispose them in some way to developing cancer. Fibroids are rarely cancerous, with the chances of such fibroids (leiomyosarcomas) arising at less than one in a thousand.  Additionally, the presence of fibroids in no way increases a patient’s chances of developing any type of cancer.

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

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 and to book a consultation, please give our office a call at 858-550-0330. 

For more information 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. 

The cause of Uterine Fibroids2022-08-18T16:47:51-07:00

Vascular Health & Uterine Fibroids

Millions of women around the world are affected by the development of uterine fibroids each year. While it is not a life-threatening condition in itself, the symptoms and potential complications that come with it make it such a pressing medical concern for affected individuals.

 

As only women will usually possess a uterus, it follows that only women are afflicted by this ailment, which is why gynecologists will often be the first ones to make a definite diagnosis. As with so many medical emergencies, knowing the problem early will greatly increase the chances of beating it, which is why the professionals at La Jolla Vein & Vascular are dedicated to administering reliable, accurate, and entirely effective diagnostics, therapies, and treatments to all clients coming through our doors.

 

Let's take a closer look at what exactly we will be dealing with should uterine fibroids turn out to be the issue at hand.

 

What are uterine fibroids? 

 

To understand what uterine fibroids are, the first thing one should do is separate the two terms making up the condition. A fibroid is a term to refer to a type of tumor that has 'muscular' characteristics. They are also referred to as a leiomyoma and can appear singularly or in formations or in lumps. 

 

They are known as uterine fibroids since they will appear in the patient's uterus. Although they are not cancerous in almost all instances, they will range in size from patient to patient, from as small as an apple seed to as large as a grapefruit and beyond, in some unusual instances. 

 

It is important for all women to be aware of the dangers presented by uterine fibroids, not only owing to the potential harm that the condition might bring about but due to the high rate of prevalence among the female population affected in some way. By the time they are 50 years old, it is estimated between 20 to 80 percent of women will have developed uterine fibroids, with most cases affecting the 40's to early 50's. 

 

Symptoms to look out for: 

 

Fibroids go undiscovered in most patients due to the lack of symptoms accompanying them, but some patients will experience some symptoms, including:

 

  • Frequent urination due to pressure being exerted on the patient's bladder
  • Lower back pain
  • Pain during sexual intercourse
  • Enlargement of the lower abdomen, with severe and extremely rare instances causing the appearance of apparent pregnancy in the patient where none exists
  • Heavy bleeding and/or painful bleeding during periods sometimes resulting in a medically significant depletion of blood in the patient (anemia)
  • Greatly increased risks of complication during pregnancy and delivery, with uterine fibroid patients requiring cesarean sections at six times the average rate.
  • Reproductive health problems such as infertility are very rare outcomes.

 

"Bringing Experts Together for Unparalleled Vein and Vascular Care"

 

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 and to book a consultation, please give our office a call at 858-550-0330. 

 

For more information 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. 

Vascular Health & Uterine Fibroids2022-08-18T16:36:29-07:00

La Jolla Vein & Vascular: Diagnosis of Peripheral Arterial Disease

Peripheral Arterial Disease – Diagnosis

At La Jolla Vein & Vascular, we have highly trained physicians who offer a comprehensive diagnosis to develop customized treatments of Peripheral arterial disease (PAD). We understand that no two patients' conditions are similar. Our full-service vascular lab provides state-of-the-art testing to ensure that our physicians address each patient case quickly and accurately. Our doctors and nurses also have broad experience in this field and use advanced tools to achieve limb-saving results even for challenging, impaired patients. Our PAD diagnosis procedure involves the following:

Detailed Physical Exam

To help diagnose PAD, our skilled doctor will start by doing a thorough physical examination. The doctor will also want to learn about your signs, symptoms, personal health history, risk factors, and family health history. The doctor will ask you several questions regarding your medical conditions, such as diabetes, heart disease, and kidney disease. They will also ask you whether you experience pain or cramps in your leg while walking or exercising.

The doctor will also ask about your family history of PAD and other heart diseases. You will also discuss your smoking habit, either current or in the past. After gathering the information, the doctor will proceed to perform a detailed physical examination. The process involves checking for weak pulses in your leg, listening for poor blood flow in the legs using a stethoscope. The physician will also check for any problems on your legs, such as sores, swelling, and pale skin.

Detailed Physical Exam

Ankle-brachial index (ABI)

Ankle-brachial index (ABI test) helps diagnose PAD. This test usually compares the blood pressure in your arm with the blood pressure in your ankle. The doctor usually uses a pressure cuff together with an ultrasound device. Sometimes, the physician may request you to walk on a treadmill and have the doctor take the readings before and immediately after the exercise. The procedure will help the doctor to capture the severity of the narrowed arteries.

Arterial Ultrasound

La Jolla Vein & Vascular doctors also use ultrasound-guided procedures to determine whether a specific vein or artery is blocked or open. The procedure is non-invasive, meaning that you will not experience any pain. The technique visualizes the artery with sound waves that measure the blood volume that flows in the veins and arteries. After the procedure, the patients receive a thorough consultation. The doctor will recommend the most effective treatment option to help promote blood flow to the feet and leg.

The treatment will help reduce leg pain, promote healing of sores and increase the mobility of the affected limb. Doctors utilize two main ultrasound methods. The first method is the Doppler ultrasound utilized to locate areas with blockages or reduced blood flow. The procedure involves using a handheld device that sends sound waves through the arteries to measure how fast blood flows. The second method is the segmental Doppler pressure testing that checks various parts of the legs for blocked or narrowed arteries. The procedure is similar to the ABI test, but the ultrasound device will amplify the sound of blood flow, making it easy to measure blood pressure.

Angiography (venography)

Angiography is minimal invasive testing that helps to visualize and diagnose blockages inside veins and arteries. In this procedure, the physician will insert a thin tube that injects a special dye that enables blood vessels to appear on an X-ray. As the dye is introduced to the arteries and veins, fluoroscopy imaging captures the detailed images to see the extent of blockages in the arteries.

Blood Tests

Doctors also take a sample of your blood to measure the levels of cholesterol and triglycerides. Blood samples are also used to check for diabetes.

Magnetic Resonance Angiography (MRA)

MRA tests are conducted to examine the structure of the arteries in your leg. However, the doctor will speak to you before using the procedure. Magnetic resonance angiography is not recommended for people with metal implants in their bodies.

 

"Bringing Experts Together for Unparalleled Vein and Vascular Care"

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 and to book a consultation, please give our office a call at 858-550-0330. 

For more information 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: Diagnosis of Peripheral Arterial Disease2022-08-18T15:52:03-07:00

What you need to know about Peripheral Arterial Disease (PAD)

Peripheral artery disease is a subset of vascular disease,also referred to as peripheral arterial disease (PAD), which develops when excessive plaque buildup on the artery walls causing the narrowing of the arteries.

The arteries deliver oxygen-rich blood from the heart to other parts of the body. When plaque builds up, it usually restricts the flow of blood, oxygen, and glucose. The obstruction causes pain in the leg as the muscles and tissues are starved for oxygen and other nutrients from the blood. While the pain usually occurs in your legs primarily, it can also be felt in other parts of the body, including your arms, stomach, hip, head, and kidneys.

Are You at Risk for Peripheral Arterial Disease (PAD)?

In most cases, the PAD symptoms are on the lower extremities. You may experience some pain, craping, or tiredness in your hip or leg muscles when climbing stairs or walking. However, the pain usually goes away with rest, only to resurface when you start walking again. Individuals suffering from peripheral arterial disease are at a high risk of coronary artery disease, stroke, or heart attack. Even worse, if left untreated, the condition can lead to gangrene and amputation.

Peripheral Arterial Disease – Symptoms

The most common symptom of Peripheral arterial disease is claudication. The fat and cholesterol build up on the artery walls cause a lack of blood flow, causing a condition referred to as ischemia. Ischemia is a condition that results when there is a greater demand for oxygen than the supply.

Claudication is a condition that causes cramping in the legs and buttocks. As mentioned, the pain and clamping flares up when you start to walk and subsides when you rest. Intermittent claudication affects about 50 percent of individuals suffering from peripheral artery disease. Some of the other common symptoms include loss of hair around the ankles, numbness or coldness in your feet.

Pain and cramping while walking may lead to a more sedentary lifestyle, meaning that the individual will burn few calories and add weight. An increase in weight also increases cholesterol, blood pressure, and other heart disease risk factors. The claudication severity often varies from mild discomfort to debilitating pain, making it hard for you to walk or perform other types of physical activities. 

Other common symptoms of the peripheral arterial disease include;

• In extreme cases, an open wound or ulcer occurs on your toes or feet. These extreme cases lead to non-healing ulcers. The ulcer can progress to gangrene, making it hard for you to walk. In such a scenario, immediate medical attention is necessary.

• Weakness or numbness in your legs

• Coldness in your lower feet, especially when you find one foot is colder than the other one.

• Experiencing pain in your feet or toes while you are resting

• Sores on the legs, feet, and toes that do not heal

• Slower toenails growth

• Change in the color of your feet

• Erectile dysfunction in men can be treated by prostate arterial embolization (PAE), which also treats benign prostatic hyperplasia (BPH)

• Weak pulse in your feet or legs

• Developing shiny skin on your legs

• Having pain in your arms, especially when writing, knitting, or performing manual tasks

As the peripheral disease progresses, you may start to experience pain even when you are lying down. In extreme cases, the pain becomes intense enough to distract your sleep. Resting your legs by hanging them at your bed edge or walking around the room helps stimulate blood flow, relieving the pain temporarily.

"Bringing Experts Together for Unparalleled Vein and Vascular Care"

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 and to book a consultation, please give our office a call at 858-550-0330. 

For more information 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 Peripheral Arterial Disease (PAD)2022-08-18T15:53:37-07:00
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Vista

Patient Privacy Practices

Privacy Policy

Hippa Privacy Practices
HIPAAOneTM Certified Seal 2

Use the search features below to find articles and insights for the diagnosis and treatment of vascular disease

TWO CONVENIENT LOCATIONS THROUGHOUT SAN DIEGO

La Jolla/ UTC

North County San Diego/ Vista — Endovascular Center
Now Open! Call/Text for Appointments

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