14, 3, 2022

How is Venous Reflux Disease Treated?

2022-03-17T10:19:57-07:00

How is Venous Reflux Disease Treated? 

 

Step 1: Identifying the underlying problem

The first step is to treat the underlying problem, venous reflux disease. The specific pattern of venous reflux disease was detected by ultrasound. Venous reflux usually starts in the saphenous veins. The saphenous veins are most effectively treated with vein ablation procedures. This involves placing a small catheter within the vein and using heat or a solution to produce injury and eventful closure of the vein. The most commonly used treatments for the saphenous veins are radiofrequency ablation (RFA), laser ablation, mechanico-chemical ablation (MOCA or Clarivein), and in some cases Varithena Foam. The treatment recommendation is customized, based on where reflux is present and other clinical factors.  

radiofreqgraphic

Step 2: Varicose Veins

 

After the underlying saphenous vein reflux is corrected, the bulging veins (varicose veins) can be treated by injecting a foamed medication that will cause them to scar and eventually dissolve (foam sclerotherapy), or to remove them using tiny incisions. The most common method is foam sclerotherapy. This is also known as ultrasound-guided foam sclerotherapy (UGFS). Both these treatments can treat venous reflux disease. 

 

Step 3: Spider Veins 

 

Spider vein treatment is always considered a cosmetic procedure. If improved cosmesis is a goal of treatment, make sure to discuss this with your doctor and plan on having cosmetic treatment as the last step. Spider vein treatment is accomplished by sclerotherapy, which is an injection of liquid medication into the spider veins. Ask your provider for an estimate about how many treatment sessions/ vials are necessary to get the results you want. 

 

How is Venous Reflux Disease Treated?2022-03-17T10:19:57-07:00

Why Was I Offered a Phlebectomy?

2022-03-17T10:19:18-07:00

Micro-Phlebectomy for varicose veins 

 

A phlebectomy is a minimally invasive procedure, which is the surgical removal of bulging varicose veins through tiny skin incisions. This procedure is performed in the office with local anesthesia. Phlebectomy is also known as micro phlebectomy (because the incisions are tiny) or it can also be referred to as ambulatory phlebectomy. 

microphlebectomy

What are the options for treating bulging varicose veins at the skin surface? 

 

There are two main techniques to treat varicose veins: 

 

  1. Phlebectomy: surgical removal of the veins
  2. Foam sclerotherapy: injection of a medicated foam to close the veins

 

Sclerotherapy is the least invasive, but patients with large and or numerous bulging veins may require several sclerotherapy appointments over two or more months. This is because we can only administer a small amount of foam medication per day and larger veins may require two or more injections to close. Larger veins can also become firm and tender after sclerotherapy and/or deposit brownish blood pigments in the skin as the veins are healing. 

 

Why was I offered a phlebectomy?

Patients with bulging varicose veins may prefer to start with micro-phlebectomy removal of the largest veins, then sclerotherapy treatment for the remaining veins. This reduces the number of appointments and accelerates recovery. 

How does the procedure work?

The skin is numbed with lidocaine, then a tiny puncture is made in the skin (about ½ the size of a grain of rice). We then infuse additional numbing medication around the veins. A small hook is used to bring the vein to the skin surface, then the vein is removed. 

 

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 taken after checking in and completing all paperwork. We will mark your bulging veins with a marker. A small hook will be used to bring the veins to the surface. More numbing medication will be infused around the veins. You will feel pressure as the veins are removed but not pain. Usually about 10-12 veins are removed.

Once the procedure is done, we will apply skin glue to the tiny puncture sites, then sterile bandages. We will help you into your compression stocking and place an ACE wrap around the treated area. You will walk for 30 minutes prior to getting in your car. The ACE wrap can be removed that night or the next day. You will wear the compression stocking for 72 hours continuously. 

 

Why Was I Offered a Phlebectomy?2022-03-17T10:19:18-07:00

The Best Way to Treat Spider Veins

2022-03-17T10:12:50-07:00

The best way to treat spider veins is through a procedure called Sclerotherapy. At La Jolla Vein Care we have seen great patient transformations with this type of therapy. If you are interested in knowing if you have spider veins, check this article out. 

 

Sclerotherapy

Why was I recommended to have sclerotherapy injections?

Spider veins and reticular veins of the legs are most commonly treated with sclerotherapy. Sclerotherapy involves an injection of a medication into the vein. This will cause the vein to collapse and gradually fade away. Sclerotherapy has been used to treat spider veins for decades, but newer solutions such as Asclera allow for spider veins to be treated with minimal discomfort and immediate return to activities.

Vein specialists rarely use saline solutions these days, because alternative solutions are less painful and better tolerated. Sclerotherapy is preferred by most vein specialists over laser because spider veins often have underlying feeder veins that can easily be treated with sclerotherapy, but are not addressed by laser. Many people will require more than one treatment session for optimal results. The national average is 2 to 5 treatment sessions. Treatment sessions are often spaced a month apart, but your health care provider will help determine your customized care plan. Wearing compression stockings after treatment will improve results. 

 

For larger veins, the medication may be turned into a foam, this is referred to as foam sclerotherapy. Foam sclerotherapy is similar to sclerotherapy of spider veins but instead of a liquid solution, a foamed-solution is injected directly into the vein via a small needle. The solution can be seen on ultrasound monitoring which allows it to be directed into nearby varicose veins painlessly. The veins will seal shut, and gradually be broken down by the body. 

 

What should I expect on my treatment days?

You will sign your consent form then change into shorts provided by the office. We will clean your skin with alcohol. The sclerosant medication will then be injected into your veins with a fine needle. After your treatment, we will help you into your compression stockings, then you will walk for 30 minutes prior to getting into your car. It is normal for your legs to be achy and tender to the touch after treatment. 

 

What should I do after treatment? 

You will be instructed on how long to wear compression stockings after treatment, depending on the size of the veins that are treated. Most patients wear thigh-high compression stockings continuously for 1-3 days, then another 7 days. You may shower with the stockings on or take a quick cool shower with them off. 

 

You should walk 30 minutes twice daily after treatment and move your legs frequently throughout the day with short walks and/or calf exercises. This avoids pooling of blood in the legs. Avoid prolonged sitting during the day. 

 

It is normal to have aching in the treated veins. This responds well to walking, ice packs, and anti-inflammatory medications such as ibuprofen (Advil, Motrin) and naproxen (Aleve). 

 

What should I avoid after treatment? 

For at least two weeks after treatment, you should avoid 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. You should also avoid airline travel for two weeks after treatment. 

 

What are the possible side effects?

You will likely have some bruising over the injection sites, then the treated veins may become firm and blue. 

 

The skin overlying treated veins may also develop brownish hyperpigmentation as the blood products within those veins are absorbed by the body; in some patients it can take up to a year to fade. Some patients temporarily develop some very fine, pink spider veins in areas where veins have been treated (telangiectatic matting). These usually resolve spontaneously over several weeks but occasionally require additional treatment to clear. If you notice the spider veins have not gone away after treatment, this information may be helpful for you. 

Below are the before and after transformations that we have seen in patient cases with spider veins and sclerotherapy.

1 the best way to treat spider veins  4

The Best Way to Treat Spider Veins2022-03-17T10:12:50-07:00

One Way To Reduce Bruising After Surgery

2022-03-17T10:10:31-07:00

One of the most common side effects after surgery is bruising. Whether it is due to plastic surgery or vein surgery, bruising and swelling are inevitable. One of the most powerful tools that we recommend for patients undergoing any type of surgery and one way to reduce bruising after surgery is RECOVA post surgery cream. 

 

Dr Nishe Bunke created RECOVA cream as a post surgical recovery cream specifically designed to reduce bruising, swelling, redness, and pain. RECOVA skin creams are packed with antioxidants and natural ingredients that promote healing and reduce inflammation. 

 

RECOVA cream aids in reducing pain, swelling, and discoloration after cosmetic surgery, injections, and procedures, laser treatments, varicose vein procedures, Sclerotherapy, minor injuries, and is one way to reduce bruising after surgery.

 

Our patients at La Jolla Vein Care have seen quick transformation post procedures. The combination of natural ingredients in RECOVA cream helps aid in quicker recovery.

 

 The powerful ingredients included in RECOVA are listed below:  

 

  • Arnica Montana is a flower extract that helps with inflammation, swelling, and bruise recovery. 

 

  • Grapeseed Oil has numerous benefits and includes numerous vitamins such as vitamin E. It is a flavonoid that aids in chronic venous insufficiency, varicose veins, and edema. 

 

  • Bromelain is an enzyme that is a natural remedy for inflammation and swelling.

 

  • Horse Chestnut is used to improve poor blood circulation, reduce swelling, and for varicose vein symptoms. 

 

  • Caprylhydroxamic Acid is an amino acid derived from coconut oil used as a gentle preservative that ensures product safety and longevity. 

 

  • Witch Hazel is used for swelling and inflammation. It is used to shrink varicose veins and hemorrhoids as well as reduce rosacea and clear redness of the skin. 

 

  • Butcher’s Broom is used for natural anti-inflammatory properties. It is used to reduce swelling and reduce varicose vein symptoms. 

 

  • Sunflower Seed Oil is packed with vitamins A, E, C, and D. 

 

  • Menthol is not present in the tinted RECOVA, since Tinted Arnica is often used around the eyes. 

 

The combination of these ingredients contributes to an overall comforting and healing sensation when applied to the skin. 

 

RECOVA is a tool that stands out due to its natural ingredients that aid in venous disease symptoms. RECOVA is hypoallergenic, and non comedogenic. RECOVA is also free of parabens, phthalates, preservatives, synthetic additives, and dyes, and never tested on animals. 

 

Patients have used RECOVA cream after vein procedures and have seen quick and lasting results. We recommend physicians offer this for patients if they complain of redness, itching, and bruising after their procedures. RECOVA offers immediate soothing relief of discomfort for our patients. 

 

Check out RECOVA online for more information and to purchase RECOVA tinted arnica cream and RECOVA post surgery cream. 

Below are a few patient transformations while using RECOVA Cream post surgical procedures.

one way to reduce bruising after surgery one way to reduce bruising after surgery

before 3 after 3one way to reduce bruising after surgery

One Way To Reduce Bruising After Surgery2022-03-17T10:10:31-07:00

21, 1, 2022

La Jolla Vein Care Doctors Make History, First to Use Live Stream Teaching in San Diego

2022-01-21T12:17:28-08:00

On Tuesday, January 18, 2022, La Jolla Vein Care doctors were the first in the region to utilize a special type of live streaming technology to teach other physicians. Over a hundred physicians around the globe dialed in to watch Dr. Armin Foghi of La Jolla Vein Care perform endovenous laser ablation (EVLA) procedures using Avail technology to livestream the procedure. Dr. Nisha Bunke of La Jolla Vein Care was the moderator. The live cases included EVLA of a great saphenous vein and of a perforator vein on patients who consented to participate. In addition to teaching, Avail, technology can be used to facilitate collaboration during procedures in real time with other physicians, sharing knowledge about surgical techniques all while bringing together the medical community to advance care for all.

avail

Dr. Armin Foghi demonstrates EVLA procedure on a perforator vein while physicians around the globe observe the case. Dr. Nisha Bunke is the moderator.

La Jolla Vein Care Doctors Make History, First to Use Live Stream Teaching in San Diego2022-01-21T12:17:28-08:00

10, 6, 2020

LA JOLLA VEIN CARE EMBRACES TELEMEDICINE AND INTRODUCES REVOLUTIONARY MOBILE ULTRASOUND SERVICES AMID COVID-19 CRISIS

2020-09-18T01:57:11-07:00

Telemedicine and Mobile Ultrasound Services Made Available throughout Southern California in an Aim to Ensure Important Health Concerns Don’t Go Untreated While Many Continue to Shelter in Place

 LA JOLLA, CALIF. (June 9, 2020) – La Jolla Vein Care (LJVC), a leader in vein treatment serving the Southern California community for more than a decade, is actively working to enhance its traditional service offerings to assist new and existing clients amid the unprecedented times brought forth by COVID-19. In a world of social distancing and self-quarantine, many individuals are postponing medical care in a bid to reduce virus exposure levels – a move many healthcare experts anticipate may lead to worsening symptoms and potentially dangerous complications down the line. To offset the concern that underlying vein diseases will go unchecked to the detriment of patient well-being while also addressing the public desire to avoid unnecessary outings; La Jolla Vein Care has deepened its commitment to best-in-class telemedicine offerings and has recently launched a new mobile ultrasound service.

“House calls are something many people see as a thing of the past, but with the inactivity of self-quarantine potentially exacerbating underlying vein diseases combined with an overall reluctance to venture out to visit a doctor, we knew something needed to be done,” said Dr. Nisha Bunke, MD, FACPh, RPhS, venous disease specialist and vein clinic medical director at La Jolla Vein Care. “We’re proud to roll out these new service offerings to meet patient needs and adapt to changing preferences during this difficult time.”

While varicose veins may be unsightly, they are not simply surface-level ailments and an ultrasound exam is required to diagnose the underlying venous diseases that cause these issues.

When left unchecked, the conditions can lead to chronic ailments like venous ulcers, but many people suffer from acute complications such as thrombophlebitis (blood clots within the veins), spontaneous vein hemorrhage, and disabling leg pain– so appropriate treatment should not be delayed, if at all avoidable.

As the first company of its kind to offer direct care to patients in their homes, La Jolla Vein Care has adopted the use of both telemedicine and state-of-the-art mobile ultrasound services via Terason uSmart 3300 NextGen technology. While telemedicine was quickly made available for consultations, pre-procedure assessments and post-procedure follow up appointments, the treatment center is advancing its accessibility initiative through new in-home mobile ultrasound diagnostics conducted by certified technicians – ushering in a new era of vein care.

Patient safety is at the forefront of LJVC’s new mobile service offerings – from the utilization of hospital-grade cloud storage systems, to cutting-edge technology that allows doctors to view results safely from a distance and adherence to all CDC guidelines including temperature checks and personal protective equipment (PPE).

Most assessments will begin with a telemedicine “visit,” followed by a mobile ultrasound screening in the patient’s home, spanning a wide radius of service area ranging from Chula Vista to San Juan Capistrano. If an in-office procedure is deemed necessary, temperature checks, ample PPE, and multiple hand-washing and sanitizing stations are available before coming into the building—and even then, only one patient will be allowed in the office at a time. Patients can conveniently wait in their cars until they are notified by text that their examination room is available.

Telemedicine and tele-radiology services are currently available to patients without additional convenience fees. LJVC accepts most PPO insurance types and considers itself now ready for the new normal of non-emergency medicine.

To book a telemedicine consultation with La Jolla Vein Care, visit https://ljvascular.com/or call (858) 550-0330.

 

LA JOLLA VEIN CARE EMBRACES TELEMEDICINE AND INTRODUCES REVOLUTIONARY MOBILE ULTRASOUND SERVICES AMID COVID-19 CRISIS2020-09-18T01:57:11-07:00

18, 4, 2020

Wendy Williams Show Kathy Bates Bring Light to Lymphedema

2021-11-15T11:03:12-08:00

Both Wendy Williams and Kathy Bates Suffer from Lymphedema.

This week’s Wendy Williams Show host, Wendy Williams discussed her struggles with lymphedema with guest, Kathy Bates who also has lymphedema. They both agreed that lymphedema is not given enough attention in medical education and in the medical community. We agree. Our medical speciality and society The American Vein & Lymphatic Society (AVLS) specializes in both vein and lymphatic disorders.

Lymphedema refers to swelling that generally occurs in one of your arms or legs. Sometimes both arms or both legs swell.  Lymphedema is most commonly caused by the removal of or damage to your lymph nodes as a part of cancer treatment. It results from a blockage in your lymphatic system, which is part of your immune system. The blockage prevents lymph fluid from draining well, and the fluid buildup leads to swelling. In our field, we also see phlebolymphedema, which is lymphedema secondary to chronic venous insufficiency. Venous hypertension can overload the lymphatic transport system, slowing fluid removal and causing subsequent lymphatic edema, in addition to venous edema. The result is swelling in the legs that is greater than venous edema.

n 2016, Kathy Bates was a speaker at our annual congress.   The American Vein & Lymphatic Society (AVLS) hosted what has become the largest and most comprehensive meeting dedicated to venous and lymphatic disorders in the U.S. Bates outspokenly discussed surviving and managing lymphedema after she had breast cancer and underwent a double mastectomy.

Lymphedema is not cured but can be managed. In our clinic, we may refer to one of our trusted lymphedema therapists for manual lymphatic drainage and prescribe compression therapy. We also offer lymphatic pump therapy in the office. It is also important to evaluate the deep and superficial venous system prior to initiating therapy.

 

Wendy Williams Show Kathy Bates Bring Light to Lymphedema2021-11-15T11:03:12-08:00

Olympic Athletes Who Suffer from Varicose Veins

2022-01-03T13:04:37-08:00

Even Olympic gold medalists get varicose veins! Including swimmers and beach volleyball players…….

It is a huge misconception that people who take care of their bodies don’t get varicose veins.  In contrast, most of our patients take great care of their health.  At La Jolla Vein Care, we routinely care for competitive athletes, marathon runners, Iron Man competitors who all suffer from varicose veins and its underlying cause venous reflux disease. We see it all.

Olympic swimmer and gold-medalist, Summer Sanders shares her story of suffering from varicose veins. “As a life-long athlete and Olympic swimmer, I never thought a condition like varicose veins or chronic venous insufficiency (CVI) would affect me. It soon hit me that, even though I was active, I was starting to get my mother’s legs.

It’s important for people to realize that varicose veins and CVI can happen to anyone and they are more than just a cosmetic issue. But you don’t have to live with the uncomfortable and painful symptoms. There are minimally-invasive treatments available that are covered by many insurance plans.

In the past, Summer shared her story as the spokesperson of a campaign called “Rethink Varicose Veins,” which aims to educate the public about this common condition and help to dispel some myths.

“Like many moms, my lifestyle requires me to be on my feet constantly. I noticed my legs were heavy and achy after a long day, but I assumed these symptoms were just something I had to deal with,” says Summer. “My doctor and I decided the best path for me was a minimally-invasive treatment. The procedure was quick and I was back to my regular activities within a short period of time. Now my legs feel great!”

Olympic gold medalist Misty May-Treanor is another athlete who is outspoken about her varicose vein condition. Misty May-Treanor has three consecutive gold medals under her belt for beach volleyball! If you are suffering from varicose veins, you are not alone!

 

Olympic Athletes Who Suffer from Varicose Veins2022-01-03T13:04:37-08:00

La Jolla Vein Care on Telemundo NBC

2021-11-04T13:50:31-07:00

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!

access total 2

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

access total 3

Office Manger, Anna is interviewed for Telemundo’s show

 

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

27, 12, 2018

Dr. Nisha Bunke Receives Business Journal Award

2020-12-19T04:05:48-08:00

La Jolla Vein Care’s Founder and Medical Director, Dr. Nisha Bunke was honored along with 24 other women, to receive the San Diego Business Journal’s, Business Women of the Year Awards 2018. Read more at the SDBJ website.

image of finalists for San Diego Business Journal Women of the Year

image of finalists for 2018 San Diego Business Journal Women of the Year

Dr. Nisha Bunke Receives Business Journal Award2020-12-19T04:05:48-08:00
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CONTACT INFORMATION

La Jolla/UTC

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

© Copyright 2010-2024, La Jolla Vein & Vascular | All Rights Reserved

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