Vascular information from Dr. Bunke

Vein & Vascular News, Tips, Treatments and More!

Laser Vein Ablation for Varicose Veins: What is it?

Laser Vein Ablation Uses Heat to Treat the Underlying Cause for Varicose Veins

Laser vein ablation, also known as endovenous laser therapy (EVLA), is a type of treatment for saphenous vein reflux, the underlying cause of most varicose veins. At La Jolla Vein Care, we offer ALL treatment modalities for varicose veins, not just one. Treatment is customized based on a person's individual pattern of venous reflux (determined by ultrasound examination), personal preference, and personal health history.

The laser vein ablation procedure may be offered for backward flow (or "reflux") in your saphenous vein(s).  The great and small saphenous veins are the two main superficial veins that run along the inner thigh/ calf and the back of the legs, respectively. Some people have anatomic variations where the small saphenous vein in the back of the calf extends to the thigh. Many people also have reflux in their anterior or posterior saphenous veins.

This minimally invasive procedure can be performed in the office in less than 30 minutes and patients 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 catheter are inserted into the vein.  The catheter delivers laser energy to the vein wall, causing it to seal shut. The remaining healthy veins continue to bring blood back to the heart.

How Laser Vein Ablation Works

What should I expect on the day of treatment?

The procedure is performed with local anesthesia but many patients elect to use a mild oral sedative (Valium), which is typically taken at check-in. Your leg will be prepped for the sterile procedure, then the doctor will perform an ultrasound to localize the vein.  Through a tiny puncture in the skin, the radiofrequency catheter is passed through the vein under ultrasound guidance.  We then use a needle to administer a combination of cool saline and local anesthetic around the vein.   This solution numbs the vein and insulates it from the surrounding tissue.  Your doctor will then treat the vein painlessly with laser energy.  Once your vein has been treated, we will help you in to your compression stocking, which you will wear for 72 hours continuously.  You will walk for 30 minutes prior to getting in your car.

What should I do after treatment?

You should walk 30 minutes twice daily after treatment.  This will alleviate discomfort and avoid the pooling of blood in the legs.   It is normal to have aching in the treated veins.  This response is well to walking, ice packs, and anti-inflammatory medications such as ibuprofen (Advil®, Motrin®) and naproxen (Aleve®).

Laser Vein Ablation steps to follow after treatment

What should I avoid after treatment?

For at least two weeks after treatment, you should avoid air travel, strenuous exercise (anything more than a brisk walk), heavy lifting, saunas or hot tubs, and leg massages.  All of these dilate the superficial veins and interfere with their healing.

What are the possible adverse effects?

Expect some bruising over the injection sites, which fades over about two weeks.  The skin overlying larger varicose veins may also develop some temporary

Endovenous laser vein ablation therapy (EVLT) uses a tiny catheter to seal incompetent veins shut.

Endovenous laser vein ablation therapy (EVLT) uses a tiny catheter to seal incompetent veins shut.

inflammation and/or brown "hyperpigmentation" as the blood products within those veins are absorbed by the body.

Less common compilations (less than 2% of patients) include clots within the deep veins or a temporary area of skin numbness over a branch of a skin nerve that travels close to a vein.

Laser Vein Ablation for Varicose Veins: What is it?2021-12-31T13:36:01-08:00

Benefits of Online MD Consultations for Varicose Veins

Connect with a vein expert from the convenience of your own home.

Benefits of Telehealth for Varicose Vein Patients

Many of us have found ourselves at home with time to think about health concerns, we have not had time to address.

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one of our 10 exam rooms at la jolla vein care clinic

Common questions our patients are asking via online / telehealth consultations are:

  1. Should I be concerned about my leg pain?
  2. What is causing my leg pain?
  3. I have lumpy veins, are these varicose veins?
  4. I have bluish-colored spots on my legs, what are these?
  5. What are the treatment options for varicose veins?
  6. Why are my legs always so fatigued?
  7. Do my varicose veins pose a health problem?
  8. Should I be concerned about varicose veins?
  9. Are these veins normal?
  10. What are these ugly leg veins?

Now is the time to ask all the questions you have ever had about your legs and vein condition.

Although we cannot see you in person, by taking a thorough history and listening to your concerns, and if you like you can send a picture of your legs by text, we can discuss your symptoms and help determine the cause of your symptoms. Because we specialize in venous disease, a lot of information can be obtained from your pictures, such as the pattern of vein disease we see on your legs is often correlated to underlying vein disease. As a result, we can come up with a preliminary treatment plan, which will then be confirmed by an ultrasound examination at our state-of-the-art diagnosis and vein treatment center, after April 30th, 2020.

Here’s a summary of the benefits of online consultation for varicose veins:

  1. Discuss your concerns with the doctor
  2. If vein treatment is desired, a preliminary treatment plan will be made, based on the appearance/pattern of veins on your legs. An ultrasound will later be required.
  3. Learn treatment options for your condition
  4. Start conservative management today- The doctor will discuss things you can do to help your legs feel better today. Insurance also requires 3 months of documented conservative management. Start your conservative management today, so you can start treatment in 3 months from now!

Telehealth Consultations are covered by most insurance types. Schedule your telehealth consultation today with Dr. Sarah Lucas:

858-550-0330 or email anna@ljvascular.com.

Benefits of Online MD Consultations for Varicose Veins2021-11-04T13:54:13-07:00

Vein Care Telemedicine during COVID

We’re here for you!

telemedicine from home

talk to our board certified doctors, vein specialist from the convenience of your home.

Connect with one of our board certified physicians at the convenience of your home.

While we remain focused on providing exceptional care, we feel it is in everyone’s best interest to move to a contact-free environment. Effective March 19th, 2020  and with a tentative ending on April 26th,  2020, the office will be closed. However, physicians will be available to patients by phone or via video conference (telemedicine) during normal business hours.

Did you know you can start your conservative management now?

Have you had concerns about your legs you have always wanted to discuss or ask about?

Now is the time. You can text us pictures of areas of concern on your leg/s ahead of time.

How to reach us:

To schedule a phone or telemedicine visit with our physicians, or any questions please call us at (858) 550-0330 or email anna@ljvascular.com.

Alternatively, you can reach us with the chat function below or text (858) 295-3347.

We are available between the hours of 8am to 5pm, Monday through Friday.

Vein Care Telemedicine during COVID2020-08-18T22:51:01-07:00

Pregnancy-Related Varicose Veins, Do Stockings Help?

Pregnancy-Related Varicose Veins, Do Stockings Help?

By Dr. Sarah Lucas

Varicose veins affect up to 30% of pregnant women, and the majority of pregnant women experience some venous insufficiency symptoms such as leg swelling, heaviness, and/or fatigue. Varicose veins most commonly emerge in the first trimester and progress over the course of the pregnancy and subsequent pregnancies. They usually improve after the baby is born, but many women never return to their pre-pregnancy state. This risk of varicose veins increases with each pregnancy, affecting more than 55% of women who have had more than two children.pregnant legs

For this reason, many patients ask what is the best approach to keeping their legs healthy during pregnancy. For the most part, the same guidelines apply to pregnant women as to other patients: keep active, wear compression stockings to control leg swelling and discomfort, and elevate the legs as needed. It is very rare for pregnant women to require surgery for varicose veins. We typically recommend patients wait at least three months postpartum or until breastfeeding is complete to get treatment.

A recent study presented at the European Venous Forum suggests that compression stockings may actually reduce the risk of varicose veins during pregnancy. Women with no history of varicose veins were randomly assigned to wear thigh-high compression stockings or no stockings starting in the first trimester.   Among the women who completed the study, varicose veins developed in 12% of those who wore stockings vs. 27% of those who did not. This was a small study (146 patients) but encouraging for women who want to are concerned about onset or worsening of varicose veins during pregnancy.

 

https://venousnews.com/varicose-veins-pregnant-compression/

Pregnancy-Related Varicose Veins, Do Stockings Help?2020-12-19T04:09:35-08:00

How to reduce bruising after vein surgery?

Learn helpful tips on Title: reducing Tips bruising for after Minimizing vein Bruising surgery. After Explore Vein practical Surgery After methods vein to surgery, minimize bruising discoloration can and be swelling common post-operation. but Discover there effective are strategies steps for you a can smoother take recovery to process. reduce its severity. Applying ice packs and keeping the affected area elevated can help minimize bruising. Following your surgeon’s post-operative care instructions diligently is crucial in promoting optimal healing and reducing bruising.

How to reduce bruising after vein surgery?

Ice: Apply ice to tender areas. Ice can reduce swelling and bruising.

Compression: Compression stockings have been shown to reduce bruising after vein stripping surgery in studies.

Homeopathic agents like arnica can help reduce inflammation and bruising. Arnica pellets can be taken prior to treatment as well and Arnica cream or gel should be applied after (not before) treatment.

How to reduce bruising after vein surgery?

How to reduce bruising after vein surgery? Picture courtesy of Medicinenet.com

Dr. Bunke's own creation, Recova Cream is an Arnica-based product, but unlike OTC Arnica preparations, combines other antioxidant, pro-healing compounds to enhance the skin's ability to repair and recover. It includes menthol, grapeseed extract, and other flavonoids that have been shown to reduce vein-related leg symptoms like leg fatigue and swelling.

RecovaCream.com for more information. Recova Cream can be purchased in-office, on amazon, or at SkinResourceMD.com.

A tinted version of Recova is available after facial procedures such as eyelid surgery, laser treatments, botox, and collagen fillers.

How to reduce bruising after vein surgery?2025-09-04T12:23:50-07:00

Veteran VA Care

We are Committed to Veteran Care

La Jolla Vein Care is now a provider for The Veterans Choice Program with Triwest. We, at La Jolla Vein Care have a special place in our heart for veterans. Dr. Bunke herself ran the vein clinic at the VA Healthcare system, San Diego for over 5 years. Dr. Bunke’s father was a NAVY SEAL and grandfather also served in the military. Dr. Lucas’ husband currently is a Naval Surgeon. We are pleased to announce that we can provide our specialty care to VA patients if their wait time is longer than 30 days. This is possible due to The Veterans Choice Program with Triwest. To learn more information about how the Veterans Choice Program works please give us a call at 1-858-550-0330

veteranman and woman web copy

 

Veteran VA Care2020-12-19T04:12:10-08:00

Height may be a genetic risk factor for varicose veins, study shows

Height may be a genetic risk factor for varicose veins

Tall patients frequently ask if their height contributed to the development of their varicose veins. Now, there may be an answer. A study at Stanford University School of mdexamining patients leg web copyMedicine study found a person’s height to be a significant risk factor for developing varicose veins. The exact reason is unknown. Intuitively, one would think the gravitational forces are greater in the leg veins of tall people. (Interesting side note, giraffes would be expected to develop varicose veins but do not: the reason for this is that their skin is firm, providing support like compression stockings). The correlation between varicose veins and height, may not be a structural or gravity-related issue but rather genetic.

 

“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.”

 

Another recent study in Russia, showed a particular gene in ethnic Russians, that was associated with the development of varicose veins, was also responsible for other traits such as rheumatoid arthritis and has a negative impact on human height, an opposite finding from the Stanford study.

 

To read more about the Stanford study, click here. 

 

Height may be a genetic risk factor for varicose veins, study shows2020-12-19T04:12:51-08:00

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