Vascular information from Dr. Bunke

Vein & Vascular News, Tips, Treatments and More!

What is a Superficial Thrombophlebitis?

A thrombophlebitis is swelling and inflammation of a vein caused by a blood clot. There are two main types of thrombophlebitits: deep venous thrombosis (affects deeper, larger veins) and superficial thrombophlebitis (affects veins near the skin surface).  This is often referred to as an STP.

The following symptoms are often associated with thrombophlebitis:

  • Inflammation (swelling) in the part of the body affected
  • Pain in the part of the body affected
  • skin redness (not always present)
  • Warmth and tenderness over the vein

The following increase your chances for thrombophlebitis:

  • Being hospitalized for major surgery or with a major illness
  • Disorders that make you more likely to develop blood clots
  • Sitting for a long period of time (such as on a long airplane trip)
  • Varicose veins

An STP is a common complication of varicose veins. But, it can also indicate an underlying problem with blood clotting.  In some cases, there may also be a concurrent blood clot in other veins, such as the deep veins (DVT) which can be serious. For this reason, a duplex ultrasound examination is used to look at the deep veins and other veins not visible to the naked eye for the presence of blood clots.

If it is localized to a small surface vein, it can usually be treated with aspirin or other anti-inflammatory medication to reduce pain and inflammation, compression stockings, and cold/warm packs to also reduce inflammation and discomfort. The discomfort is usually improved within 6 weeks but it can take a few months to resolve.

If the superficial thrombophlebitis is extensive or if it appears to be ‘migrating’ up the leg, a blood thinner may be necessary.  You should see your doctor if you develop an STP.

stp

A thrombophlebitis is swelling and inflammation of a vein caused by a blood clot. This patient has superficial thrombophlebitis, which is a blood clot in the superficial, surface veins. You can see redness in the inner thigh of this patient, which is caused by the inflammation and swelling from the blood clot. It can be very painful. You should see your doctor for superficial thrombophlebitis.

 

What is a Superficial Thrombophlebitis?2022-01-03T12:52:21-08:00

Have Tea with the Vein MD August 11th

La Jolla Vein Care is announcing their new ‘Tea with the MD’ series of educational seminars for patients to learn more about varicose veins, what causes them, what’s new in treatment, etc.  Dr. Bunke will be kicking off the first seminar Monday, August 11th.  This is an opportunity to ask the doctor all of your vein related questions in a small group.  Those who are interested are asked to call 858-550-0330 to RSVP as space is limited to keep the discussions quaint.  Light snacks/lunch will be served and parking will be validated. Tea-With-MD-Ad-print

Have Tea with the Vein MD August 11th2021-11-04T15:19:57-07:00

Is Darkening of the Skin A Sign of Venous Disease?

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When the skin becomes darker around the ankles, it may indicate underlying venous insufficiency. If you notice that your skin around the ankles changes color, you should see your doctor. Venous insufficiency can be diagnosed with ultrasound scanning by specialists.

Is Darkening of the Skin A Sign of Venous Disease? Yes.   Skin discoloration, also referred to as skin hyperpigmentation or venous stasis, describes the darkening of the skin as a result of venous insufficiency.    This is most frequently cause by venous reflux, an underlying condition that can be treated. When skin changes like these are present, the condition is termed chronic venous insufficiency.  Over time, the skin condition may worsen and the skin may become darker, firm to touch, scaly and itchy, and the skin may break down causing a venous leg ulcer.  It usually occurs around the ankles.  

Is Darkening of the Skin A Sign of Venous Disease?2025-09-04T12:33:20-07:00

Should I Wear Compression When I Travel to Prevent a DVT?

Should I Wear Compression When I Travel to Prevent a DVT?

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Using compression stockings during travel can reduce the risk of developing a flight-related deep venous thrombosis (DVT).

Yes. Compression stockings are great to use during air travel and long trips where you will be sitting for long periods of time. When you sit for long periods of time you are more at risk of blood clots and swelling. Compression stockings can reduce your risks and prevent swelling.  Ask your doctor the strength that is recommended for you.

Should I Wear Compression When I Travel to Prevent a DVT?2021-11-05T13:04:03-07:00

Why Compression Socks?

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Olympic champion and Boston Marathon winner, Meb Keflezighi wears CEP compression socks while running. CEP compression socks can be found at compressrx.com.

Graduated compression stockings apply external pressure to your legs reducing venous pressure. Graduated compression stockings are great to use if your want to increase circulation, support you leg veins, and want to reduce uncomfortable leg symptoms such as swelling, tired and achy feeling legs.

They are important in the conservative management of varicose veins to reduce symptoms. They are also used after any type of vein treatment to improve the effectiveness of treatment, to reduce bruising and swelling, and for comfort.

Anyone can benefit from compression stockings. Compression stockings are great for relieving ones symptoms when sitting, standing or moving around for long periods of time. They are also great for professionals such as nurses, hairdressers, desk workers, and everyone in between.

Athletes wear compression stockings too.  There is some evidence that medical compression helps to reduce muscle fatigue and improves muscle recovery.  But, not all compression socks are made equal.  They should be medical graduated compression, like CEP socks by Mediven. These are the socks preferred by Olympic champion and Boston Marathon winner, Meb Keflezighi wears CEP compression socks while running.   Find medical CEP compression socks at compressrx.com.

 

Why Compression Socks?2014-07-30T16:21:32-07:00

Before and After Pictures: Varicose Veins

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Before and After Photo: Varicose Veins. This patient had non-surgical vein removal of large varicose veins along the inner calf at La Jolla Vein Care.
To view more before and after photos and results from varicose vein treatments, go to La Jolla Vein Care’s photo gallery.

Before and After Pictures: Varicose Veins2021-11-04T20:15:13-07:00

Laser and Radiofrequency Vein Treatments

What is the difference between laser and radiofrequency procedures for varicose veins?

Both laser and radiofrequency ablation techniques are used as an alternative to surgery for the treatment of varicose veins and underlying venous insufficiency.  The concept behind both laser and radiofrequency treatments is that an energy source is used to heat the vein, causing it to collapse and seal shut. Over time, the treated veins will dissolve. This is offered as an alternative to surgical removal of the veins. The basic difference between the two, are the types of energy sources used.

Laser vein treatment, also known as laser ablation or endovenous laser ablation therapy (EVLT or EVLA) utilizes laser energy to heat the vein.

Radiofrequency vein treatment, also known as radiofrequency ablation (RFA), or the Venefit procedure (previously known as VNUS Closure) utilizes radiofrequency energy to heat the vein.

Both procedures are used to treat the small, great or anterior saphenous veins.

Either procedure involves making a tiny incision the size of a grain of rice on the skin, and a narrow catheter is inserted into the vein. The machine applies either laser or radiofrequency energy to the vein interior, an action that heats the vein and seals it closed.

Unlike traditional surgery, this new minimally invasive procedure takes about 30 minutes to perform and patients can walk out of the office afterward.

While both are effective options for vein treatment, we prefer radio-frequency ablation over laser because it has been proven to be more comfortable than laser yet equally effective. It is also our experience that there is less bruising,  pain, and quicker recovery associated with radio-frequency closure of the veins.

Slide23

Laser vein treatment, also known as laser ablation or endovenous laser ablation therapy (EVLT or EVLA) utilizes laser energy to heat the vein.
Radiofrequency vein treatment, also known as radiofrequency ablation (RFA), or the Venefit procedure (previously known as VNUS Closure) utilizes radiofrequency energy to heat the vein.

Slide24

The radiofrequency catheter is inserted inside the vein. Radiofrequency energy then heats the vein causing it to collapse and seal shut. We prefer radiofrequency over laser vein treatment because we find that it is more comfortable for the patient with less bruising.

Remember, that more than one treatment type is often needed such as radiofrequency of the saphenous vein + sclerotherapy of superficial branches. Talk to your doctor to find out which is best for you or schedule a consultation at 858-550-0330.

 

Laser and Radiofrequency Vein Treatments2021-11-04T20:20:33-07:00

What is Stasis Dermatitis?

Stasis dermatitis or venous stasis dermatitis is a change in the skin that occur when blood collects (pools) in the veins of the lower leg. ‘Stasis’ refers to pooling of the blood in the lower legs from venous insufficiency, and ‘dermatitis’ refers to the inflammation and related skin changes. Because of the inflammation, the skin around the ankles is usually itchy and discolored.

At first, the skin of the ankles and lower legs may look thin or tissue-like. You may slowly get brown stains on the skin.

The skin may become irritated or crack if you scratch it. It may also become red or swollen, crusted, or weepy.

Over time, some skin changes become permanent:

  • Thickening and hardening of the skin on the legs and ankles (lipodermatosclerosis)
  • A bumpy or cobblestone appearance of the skin
  • Dark brown color
Stasis Dermatitis with Ulceration

Chronic venous insufficiency over time can lead to skin changes and eventually ulceration. This image demonstrates stasis dermatitis (also known as venous dermatitis). Stasis dermatitis refers to the skin changes including skin discoloration around the ankles, dry itchy skin that can be thin, and it may eventually break down to cause an ulceration. You need to see a doctor if these signs are present.

Skin sores (ulcers) may develop (called a venous ulcer or stasis ulcer). These most often form on the inside of the ankle.  For this reason, whenever stasis dermatitis or skin changes are noticed around the ankle, you should see your doctor or vein specialist to stop the progression of venous insufficiency and prevent the skin from forming an ulceration.

  

 

What is Stasis Dermatitis?2021-11-05T13:05:00-07:00

8 Warning Signs of Vein Disease: #5 Pregnancy Related Varicose or Spider Veins

Pregnancy

Pregnant women should talk with their doctors about using medical compression therapy during pregnancy to reduce the risk of varicose veins and vein related issues.

8 Warning Signs of Vein Disease: #5 Varicose or Spider Veins, especially during or after pregnancy. During pregnancy, the amount of blood greatly increases throughout the body to almost double the normal volume, stretching leg veins far beyond their normal capacity.  Even though the visible signs of varicose veins may disappear after birth, the damage done to veins during pregnancy may be permanent and can cause pain and discomfort later in life. These problems may be avoided if compression therapy is prescribed during pregnancy. Women with a history of vein disease in their family or who experience swelling, pain or varicosities in the their legs during pregnancy are strongly urged to talk to their doctors about medical compression therapy or be evaluated by a vein specialist.

8 Warning Signs of Vein Disease: #5 Pregnancy Related Varicose or Spider Veins2014-07-22T21:10:22-07:00

Varicose Veins vs. Spider Veins

What is the difference between varicose veins and spider veins?  Are they the same thing? Spider veins and varicose veins both refer to dysfunctional, dilated leg veins but the main difference is the size of the veins. Spider veins are small, thread-like veins at the surface of the skin. They often appear in clusters or can have a ‘starburst’ or spider-like pattern. Varicose veins are larger veins that appear swollen, twisted cordlike veins that ‘bulge’ at the surface.

Both spider veins and varicose veins can cause pain and other symptoms like burning, aching, and throbbing. Both can be treated without surgery.

Slide 4_2

This image describes the difference between spider veins and varicose veins. Both are manifestations of unhealthy veins. Spider veins are essential, tiny varicose veins.

Varicose Veins vs. Spider Veins2021-11-05T13:08:51-07:00

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