Vascular information from Dr. Bunke

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What Your Ankles Say About Your Health

5 signs of venous reflux disease were found on the ankles

venous reflux disease were found on the ankles

Venous reflux disease refers to ‘leaky valves in the leg veins. It is also referred to as venous insufficiency. When the one-way valves that help blood in the veins flow from the feet to the heart, no longer work properly, blood begins to pool around the ankles. Over time, the pooling of blood causes increased hydrostatic pressure within the blood vessels. This is referred to as venous hypertension in the medical community. Venous hypertension is associated with chronic venous insufficiency, which means the vein valves have become leaky for a long time before physical signs are apparent. An ultrasound examination can first identify if the underlying veins are weak and leaky not visible to the naked eye, long before physical signs become apparent. Some signs you may see that may indicate underlying venous reflux disease include:

chronic venous insufficiency or venous reflux disease

Darkening of skin, and itchiness are a sign of chronic venous insufficiency or venous reflux disease

  1. Skin darkening around the ankle (hyperpigmentation). This is also referred to as venous stasis. This is a result of long-standing venous reflux or pooling of blood.
  2. Itchy, scaly skin around the ankles. This is referred to as venous eczema. This skin becomes itchy and scaly from chronic inflammation.
  3. spider veins in the inner ankle. These are commonly associated with venous reflux in the great saphenous vein. The great saphenous vein courses the ankle all the way to the groin. When blood pools from thigh upper thigh all the way to the ankle, small spider veins may appear in the ankle. These are commonly perceived as cosmetic because most people don’t realize there is an underlying problem.
  4. ankle swelling (edema). There are many causes for ankle swelling. Some are serious like heart conditions where others are less serious like a salty diet. When ankle swelling is present talk to your doctor about the various causes. However, one of the most common causes of ankle swelling is venous reflux disease. Anyone who has ankle swelling can benefit from an ultrasound examination to determine if venous reflux disease is present.
  5. skin ulceration and breakdown in the ankle. Over time, pooling of blood in the ankles and venous hypertension causes the skin to darken, it can become scaly and itchy and eventually ulcerate because the skin breaks down from chronic inflammation. This is called a venous leg ulcer. Venous leg ulcers are treated by treating the underlying venous reflux disease.

All of these signs and symptoms can be reduced by treating the underlying problem, venous reflux disease. See our treatments page to better understand treatment options.

What Your Ankles Say About Your Health2021-11-13T13:50:53-08:00

La Jolla Vein Care on Telemundo NBC

La Jolla Vein Care interviewed about innovative solutions for varicose veins on Telemundo’s Total Acceso.

La Jolla Vein Care was recently featured on Acceso Total, on Telemundo. Office Manager, Anna who is bilingual was interviewed in Spanish and talked about our clinic and what sets up apart from the rest. Patient stories were also given by actual La Jolla Vein Care patients. See our youtube channel to watch this feature.  We are proud to be selected for this feature and enjoyed working with this wonderful crew at Telemundo!

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Dr. Bunke demonstrates saphenous vein on ultrasound to Access Total.

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Office Manger, Anna is interviewed for Telemundo’s show

 

La Jolla Vein Care on Telemundo NBC2021-11-04T13:50:31-07:00

What Leg Venous Vein Ultrasound Can Uncover About Your Veins

Most vein disease is not visible to the naked eye.

What Leg Vein Ultrasound Can Uncover About Your Veins: blood clots and leaky valves

Leg Vein Ultrasound

We can see beneath the surface of the skin with ultrasound. Duplex ultrasound combines Doppler flow information and conventional imaging information, sometimes called B-mode, to allow physicians to see the structure of your blood vessels. Duplex ultrasound uses sound waves to get images of your blood vessels.  It also helps determine how fast blood moves through the vessels. It can also be useful to estimate the diameter of a blood vessel as well as the amount of obstruction, if any, in the blood vessel. Using duplex ultrasound technology, the structure of your blood vessels, the valve function, the movement of your red blood cells, and the direction of blood flow through the vessels, any blockages, blood clots, and leaky valves can be seen.

Venous Reflux (leaky valves)

Duplex ultrasound of the leg veins

Ultrasounds of the leg veins that look for leaky valves (venous reflux) are usually performed in the standing position.

The Duplex Ultrasound examination allows us to visualize the blood vessels that are not visible to the naked eye, even blood vessels that are deep within the muscles.  Ultrasound looks at deep and superficial veins in the legs to check for venous reflux or venous-valvular incompetence (the underlying condition that causes varicose veins). The ultrasound examination is used to both identify the veins that have faulty valves and to map the anatomy of the veins, creating a ‘road map.’  This is necessary to make an accurate assessment of the cause and extent of the varicose veins, as well as to formulate the best treatment plan.  This should be done for any individual being evaluated for varicose veins, leg swelling, patients who have failed prior treatment, patients who are symptomatic, and in some patients with certain anatomic patterns of spider veins.

Before your test:

This study does not require any preparation. You should not wear your compression stockings the same day as the examination.  Make sure to be hydrated.

How long does it take?

An ultrasound only checking for blood clots typically takes less than 30 minutes. An ultrasound that looks at both the deep and superficial veins including mapping is less than 60 minutes, the part of this exam that checks if the valves are leaky is performed in the standing position.

What Leg Venous Vein Ultrasound Can Uncover About Your Veins2021-12-31T13:46:54-08:00

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
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