26, 4, 2022

La Jolla Vein and Vascular welcomes Jodi Hirsch, PA-C

2022-04-23T14:24:17-07:00

La Jolla Vein and Vascular welcomes Jodi Hirsch, PA-C

jodihirsch

Jodi Hirsch PA-C is a board-certified physician assistant who has spent her career specializing in the field of peripheral vascular disease and venous disease.  She gained her undergraduate degree in chemistry and pursued her degree in Physician Assistant Studies from Touro University in NY in 2006. She has spent her professional career in San Diego, previously working in the Department of Vascular Surgery at Scripps. When not at work, she enjoys spending time with her husband and two little boys.

For more information please watch Jodi’s video here.

La Jolla Vein and Vascular welcomes Jodi Hirsch, PA-C2022-04-23T14:24:17-07:00

Two Venous Reflux Disease Treatments for visible bulging veins

2022-04-15T15:32:43-07:00

 

Two Venous Reflux Disease Treatments for visible bulging veins include: 

 

Asclera, and Phlebectomy. We at La Jolla Vein Care offer a variety of methods for vein disease. Below is some helpful information about both procedures. 

 

Ultrasound-guided foam sclerotherapy works well for treating surface varicose veins and veins that are not visible to the naked eye. The foam medication can be seen on ultrasound, which allows us to administer it precisely and direct it towards nearby varicose veins. Foam sclerotherapy can be safely used for bulging veins that travel close to the skin or nerves. It also travels easily through veins with many twists and turns.

Asclera for bulging veins:

A variety of sclerosant medications can be used for veins, but we prefer polidocanol (brand name Asclera®) because it is the most comfortable for the patient and has the lowest risk of side effects. It is a detergent-type medication that injures the inner lining of the veins. This causes the vein to stop flowing, then eventually close down completely. Polidocanol has been well-studied and has been approved by the FDA since 2010 for the treatment of varicose veins and has been used in Europe for decades. Polidocanol is turned into a foam to treat larger veins. This is an off-label use of the sclerosant but very effective and well tolerated. La Jolla Vein Care providers have extensive experience with foam sclerotherapy for the treatment of bulging veins. 

How many treatments will I need?

The number and frequency of treatments depends on a patient’s anatomy, how well the veins respond to each treatment, and the patient’s treatment goals. The national average is 2 to 5 treatment sessions to achieve 80% improvement. Some larger or resistant veins require two or more treatments to respond completely.

Phlebectomy Procedure: 

Phlebectomy is the surgical removal of bulging veins though tiny skin incisions. This minimally invasive procedure is performed in the office with local anesthesia. Phlebectomy is also known as micro phlebectomy (because the incisions are tiny) or ambulatory phlebectomy.

WHAT ARE THE OPTIONS FOR TREATING BULGING  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 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.

Phlebectomy

HOW DOES THE PROCEDURE WORK?

The skin is numbed with lidocaine, then a tiny puncture is made in the skin (about half 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.

 

Two Venous Reflux Disease Treatments for visible bulging veins2022-04-15T15:32:43-07:00

What is VenaSeal?

2022-04-15T11:21:27-07:00

The U.S. Food and Drug Administration (FDA) approved the VenaSeal Closure System to permanently treat varicose veins by sealing the affected superficial veins using an adhesive agent.

vseal

The VenaSeal Closure System is a unique, minimally invasive treatment that uses a safe-for-the-body medical glue to quickly and effectively treat varicose veins (venous reflux disease). Using ultrasound, a doctor will guide a tiny catheter through a small access site in the skin and into the diseased area of the vein. Next, the VenaSeal dispenser delivers a very small amount of medical glue to close the vein. Once the affected vein is closed, blood is immediately re-routed through other healthy veins in the leg.

Unlike other treatments, it does not require anesthesia to be injected into the leg via multiple needle sticks (tumescent anesthesia), and because there are no pre-procedures drugs involved, patients can return to their normal activities right after the treatment. Unlike heat-based procedures, with VenaSeal there is no risk of skin burns or nerve damage. VenaSeal usually does not require any post-treatment pain medication or uncomfortable compression stockings.

procedure

The VenaSeal closure system is the only non-tumescent, non-thermal, non-sclerosant procedure that uses a proprietary medical adhesive delivered endovenously to close the vein. This unique approach eliminates the risk of nerve injury when treating the small saphenous vein, which is a risk sometimes associated with certain thermal-based procedures. Clinical studies have demonstrated that the procedure is safe and effective.

Call La Jolla Vein Care at 858-550-0330 to find out if VenaSeal is a good option for your vein treatment!

Check out our youtube channel for more information on VenaSeal.

 

What is VenaSeal?2022-04-15T11:21:27-07:00

Spider Veins Before and After Patient Transformation

2022-04-13T11:56:42-07:00

What are spider veins?

They are the fine, thread-like reddish veins at the surface of the skin, and are often considered a cosmetic issue, but they can be associated with underlying feeder veins, not visible to the naked eye.  Feeder veins are the ‘blue veins’ also known as ‘reticular veins,’ that give rise to spider veins. They may also be a sign of underlying venous insufficiency. For example, they are usually located in the inner ankles and inner thighs can indicate an underlying problem with the saphenous vein. As a result, an ultrasound examination may be recommended to identify and effectively treat the underlying source.

What are the symptoms?

Vein conditions affect people differently. For some, they can be a painless cosmetic concern, and for others they may cause symptoms. The most common symptoms are burning, throbbing, and localized pain. They can also feel hot and itchy and bleed.

What are the causes?

They are caused by the same condition that causes varicose veins. Leaky vein valves allow blood to pool within the veins causing them to stretch and become enlarged. Spider veins on other areas of the body, such as the face, and chest can be caused by sun damage, hormone changes or liver disease. Hormones, such as with pregnancy, birth control or hormone replacement therapy can weaken the vein wall.

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 modern solutions such as Asclera, allow for spider veins to be treated with minimal discomfort and immediate return to activities.

 

Below are La Jolla Vein Care patient transformations before and after vein treatment for spider veins. 

spider veins

spiderveins2

spider veins

Spider Veins Before and After Patient Transformation2022-04-13T11:56:42-07:00

3 Venous Reflux Disease Treatments for underlying vein reflux

2022-04-12T10:08:56-07:00

3 Venous Reflux Disease Treatments for underlying vein reflux:

 

The ClariVein procedure

When someone is diagnosed with underlying vein reflux disease, the ClariVein procedure is for the 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 for vein reflux disease.  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 underlying diagnosis of vein reflux disease, which can cause a  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.

 

3 Venous Reflux Disease Treatments for underlying vein reflux2022-04-12T10:08:56-07:00

What is ClosureFast?

2022-04-11T10:20:19-07:00

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.

closurefast1

How does the ClosureFast 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 should I expect on the day of treatment?

closurefast2

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.

 

What is ClosureFast?2022-04-11T10:20:19-07:00

How Cholesterol Affects Your Vascular Health

2022-04-05T12:23:27-07:00

How cholesterol affects your vascular health

When it comes to vascular disease, cholesterol is enemy number one. Cholesterol is a waxy, fat-like substance found in the walls of human cells. The human body produces cholesterol but it also comes from foods that are high in animal fats such as eggs, cheese and meat.

But all cholesterol is not created equal. It comes in two very different types:

  • Good cholesterol, or high-density lipoprotein (HDL), helps keep arteries from becoming blocked.
  • Bad cholesterol, or low-density lipoprotein (LDL) can build up and cause blockages in the arteries.

Triglycerides are fats produced by the liver. They can cause the same kinds of health problems as LDL. Over time, a buildup of extra cholesterol, or plaque, can narrow the insides of blood vessels. Eventually, the plaque causes hardening of the arteries, also called atherosclerosis. This condition can lead to vascular disease, strokes, heart attacks, aneurysms and other life-threatening problems.

When doctors tell you to “know your numbers,” one of those numbers is your cholesterol level. For good vascular health:

  • Total cholesterol should be less than 200.
  • Good cholesterol (HDL) should be more than 60. 
  • Bad cholesterol (LDL) should be less than 130.
  • Triglycerides should be less than 150.

Why take statins for cholesterol control?

All types of atherosclerosis are improved when patients take statins.

Side effects are relatively rare, and if a patient does not tolerate one statin, there are many different ones that can be tried.

What are statins?

Statins act as a key control point in the metabolism of serum cholesterol.

Specifically, when “bad” (LDL) cholesterol is high, the risk of heart attack and stroke is high.

Can lifestyle changes impact cholesterol levels?

Yes. Even slight lifestyle choices can impact vascular disease. For example, a 10-pound weight loss can result in a 5 to 8 percent reduction in LDL.

If lifestyle changes are not enough to bring your numbers to a healthy level, medication may help. Total cholesterol levels that are borderline high (between 150-199 mg /dL) or high (200 mg / dL or more) may require treatment with a statin drug. Some conditions actually benefit from a statin even if your numbers are normal.

Who benefits from taking statins?

  • People who are at risk of heart attack and stroke due to high cholesterol
  • Patients with hardening of the arteries supplying oxygen-rich blood to the brain or the legs
  • Vascular surgery patients. During a vascular procedure, they have fewer complications

Do statins affect plaque in the blood vessels?

Newer research suggests that statins don’t just stop plaque from getting worse, they may also reduce plaque in the leg arteries. Studies also now suggest that statins keep plaque stable so it is less likely to break off and form blood clots that cause heart attacks and strokes. Statins also improve the function of cells inside of the artery.

Don’t statins have side effects?

Few statin side effects have been recorded since they were introduced 40 years ago. Most mild side effects, such as muscle pain and cramps, can be avoided by switching statins. Serious side effects are rare but it is important to be aware of them. They include:

  • Liver damage. This very rare condition doesn’t cause symptoms, so laboratory tests are ordered when patients first start taking statins.
  • A wide range of muscle injuries. In rare cases, inflammation of the muscles can occur. At its worst, this rapid muscle destruction can lead to kidney failure.

 

How Cholesterol Affects Your Vascular Health2022-04-05T12:23:27-07:00

Smoking and Vascular Disease

2022-04-04T14:53:33-07:00

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.

 

Smoking and Vascular Disease2022-04-04T14:53:33-07:00

Diabetes and Vascular Health

2022-04-01T08:55:27-07:00

Diabetes and Vascular Disease

Diabetes Mellitus is a disease that affects the body’s ability to absorb glucose, which is a form of sugar and a major source of energy. There are two types of diabetes, Type 1 (formerly known as juvenile diabetes) and Type 2 (formerly called adult onset diabetes).

Both cause high levels of glucose in the bloodstream. High blood sugar causes many of the long-term effects of diabetes. Too much sugar in the blood damages the linings of the arteries of all sizes, and that can cause atherosclerosis, in which arteries are weakened and/or clogged with plaque.

Atherosclerosis in diabetic patients can lead to:

  • Kidney damage. Kidneys have tiny blood vessels that remove waste from the blood, but diabetes blocks these blood vessels. As the disease progresses, the kidneys lose function and eventually fail.
  • Retinopathy. High blood sugar can cause tiny blood vessels in the eyes to become blocked. When your eye tries to grow new blood vessels, they grow abnormally, eventually leading to blindness.
  • Peripheral artery disease. Glucose damage to the arteries that feed oxygen and nutrients to the legs and feet can lead to pain in the legs, foot sores that won’t heal, chronic pain from poor circulation and in some cases, amputation.
  • Neuropathy. In this condition, the patient loses feeling in the feet and toes. Decreased blood flow caused by clogged arteries can damage the nerves in the extremities.

If you or someone in your family has diabetes, be aware that:

-Patients with diabetes are more likely to get vascular disease.

-Patients with both diabetes and vascular disease are at risk of amputation, blindness, kidney failure and other serious disabilities.

Treatment of diabetes:

Because of the effects, it is very important to aggressively treat both types of diabetes to minimize long-term damage. Careful maintenance of the blood glucose level is the primary goal of this treatment. The HbAl c is a test that estimates the averaged glucose level over a three-month period. Maintaining an HbAl c < 7% is known to lower the risk of amputation, heart attacks, stroke and onset of peripheral arterial disease.

 

Avoiding foods and snacks high in sugar (which can include seemingly innocuous items such as white bread and pasta) can help maintain healthy glucose control. In addition, exercise helps to burn energy and improve your body’s ability to keep your glucose at a healthy level.

Ultimately, medication is often required to maintain this control. For type 2 diabetes, it has been shown that use of an insulin sensitizing medication (usually an oral agent) dramatically decreases cardiovascular complications compared to using only insulin. Consultation with a diabetes specialist can help you to manage your diabetes optimally. There are many new ways to check your glucose at home, including phone apps, and this knowledge and feedback can help you to manage your A1c better.

 

Preventive Care

Preventive care is a critical component of limiting lifetime complications for diabetics. Diabetes predisposes one to heart attacks, strokes, kidney failure and peripheral arterial disease. Knowing the signs and symptoms of these can facilitate you seeking help before a tragic event occurs. However, diabetes can also blunt the usual nerve response to diseases such as the pain of peripheral artery disease. This loss of sensation results in an increased risk of pressure ulcers on the feet. Patients with diabetes should perform routine inspection of their feet to evaluate for any breaks in the skin and notify their doctor immediately if found.Often, nail care can be complicated in diabetic patients. If you have been told you have peripheral neuropathy, ask for a referral to a podiatrist to assist you with nail care to avoid potentially dangerous injuries in nail care. If you do develop any wounds on your feet that do not heal in a reasonable time or seem to be expanding, ask your doctor to refer you to a vascular surgeon here at La Jolla Vein Care.

 

Diabetes and Vascular Health2022-04-01T08:55:27-07:00

31, 3, 2022

Physical Activity and Vascular Health

2022-03-31T11:45:50-07:00

Physical activity helps to burn calories, increase the heart rate, and keep blood flowing at a healthy rate. All of these contribute to vascular health. 

If your doctor has diagnosed you with vascular disease, or if you have concerns about your vascular health, starting some good habits can help keep vascular complications at bay. Daily exercise has been found to have a significant positive effect on vascular health, along with other good lifestyle choices, such as not smoking, eating heart-friendly foods and maintaining a healthy body weight.

Your Vascular Health

Exercise can impact several artery diseases. A regular exercise routine may reduce the risk of stroke, the fourth leading cause of death in America according to the CDC’s 2010 National Vital Statistics Report. In 2010, 137,000 Americans died of stroke. Studies show that patients with peripheral arterial disease (PAD) may be successfully treated with exercise therapy and possibly avoid interventions. Regular exercise also decreases the growth rate of abdominal aortic aneurysms (AAA), research has found.

The United States Centers for Disease Control and Prevention (CDC) recommends 150 minutes of physical activity per week for adults ages 18 to 64. The activity can be a combination of moderate intensity aerobics and strength training, and should continue for at least 10 minutes at a time.

Moderate-intensity aerobic activities that increase the heart rate and cause sweating which are great for vascular health:

  • Riding a bicycle at a casual pace 
  • Playing doubles tennis
  • Actively playing with children
  • Mowing the lawn
  • Gardening, raking, or bagging leaves
  • Light snow shoveling
  • Water aerobics
  • Ballroom dancing

Vigorous activity that increase the heart rate that are great for vascular health:

 

  • Hiking uphill or with a heavy backpack,  race walking, jogging, running
  • Riding a bicycle fast or riding hills, more than 10 miles/hr
  • Rollerblading / inline skating at a brisk pace 
  • Playing basketball, football, soccer, etc.
  • Cross-country skiing
  • Jumping rope
  • Aerobic dancing
  • Heavy gardening continuous digging and hoeing
  • Swimming laps
  • Playing singles tennis

Twice weekly strengthening activities include:

  • Sit-ups, push-ups
  • Weight lifting
  • Heavy gardening such as digging and shoveling 
  • Yoga

The lack of regular physical activity results in 250,000 deaths annually, according to a 2003 report in the medical journal, Circulation. People who are the least physically fit have a mortality risk 4.5 times higher than physically fit people.

To add physical activity into your daily schedule:

  • Select enjoyable activities 
  • Work out with a friend
  • Encourage family members to participate
  • Measure progress through a daily exercise journal

 

Physical activity is not just good for your veins and arteries, just about every part of your body can benefit. According to the CDC, exercise also helps your vascular health and in addition helps:

  • Maintain healthy weight
  • Reduce the risk of cardiovascular disease; can lower blood pressure and improve cholesterol levels
  • Reduce the risk for type 2 diabetes; can help control glucose levels
  • Reduce the risk of colon and breast cancer
  • Strengthen bones and muscles – can increase or build muscle mass and strength; can slow the loss of bone density that comes with age; can help with arthritis and other joint conditions
  • Keep thinking, learning, and judgment skills sharp 
  • Reduce the symptoms of depression and anxiety
  • Improve the ability to complete daily activities and prevent falls for older adults
  • Increase the chances of living longer by reducing the risk of dying from heart disease and some cancers

 

Physical Activity and Vascular Health2022-03-31T11:45:50-07:00

informacion en español

Visita nuestra página en español

https://ljvascular.com/informacion-en-espanol/

Go to Top