19, 4, 2023

Radiofrequency Ablation for perforator vein reflux

2023-02-15T15:55:23-08:00

Radiofrequency perforator ablation is performed on perforator veins, short connections between your deep and superficial veins. Perforator veins can suffer the same sort of valve damage and retrograde blood flow (venous reflux) as other veins. Most patients with vein disease who experience skin changes, (that also may result in leg ulcers if left untreated) have reflux in perforator veins near their ulcers, as well as in the superficial or deep veins.

Perforator

What are Perforator Veins?

Perforator veins serve as connections between the two networks of veins in the extremities, the superficial venous system and the deep venous system. Perforators connect the two parallel systems, and normally drain blood from the superficial veins to the deep veins as part of the process of returning oxygen-depleted blood to the heart.

Perforator veins have one-way valves designed to prevent backflow of blood down towards the superficial veins. When those valves no longer function properly and reflux occurs, the buildup of blood and pressure can cause not only the superficial veins but the perforators themselves to become incompetent. Perforator veins in the lower leg and ankle are particularly vulnerable to distention and incompetence, and the resultant circulatory problems create an increased likelihood of edema, skin discoloration, dermatitis and skin ulcers in the immediate area.

Perforator

Your doctor may have recommended treatment of your perforator vein(s) because it is contributing to:

  • Venous leg ulcers
  • Pre-ulcerative skin changes
  • Persistent or recurrent varicose veins
  • Leg pain
  • Leg swelling

 

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 


Radiofrequency Ablation for perforator vein reflux2023-02-15T15:55:23-08:00

Saphenous Vein Reflux Treatment

2023-02-15T15:47:21-08:00

ClosureFast™ an endovenous radiofrequency ablation (RFA) procedure

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.

saphenous

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 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

Diagram of endovenous laser ablation (EVLA) procedure

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 listen to music.  Once you are comfortable, you leg (s) will be prepped with 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.

 

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 


Saphenous Vein Reflux Treatment2023-02-15T15:47:21-08:00

Patient Reviews & Testimonials

2023-02-15T15:40:22-08:00

La Jolla Vein & Vascular is a state-of-the-art medical center dedicated exclusively to the diagnosis and treatment of vein and arterial conditions for patients. 

 

Vein conditions of patients we have treated include varicose veins, spider veins, and venous leg ulcers, chronic venous insufficiency, edema, lymphedema, and deep vein thrombosis.  Arterial conditions and treatments such as peripheral arterial disease (PAD), atherectomy, angioplasty, stenting.  We also offer prostate artery embolization (PAE) to treat BPH, varicocele embolization for men and uterine fibroid embolization (UFE), pelvic venous congestion (PVCS), pelvic and labial varicose veins for women.  Osteoarthritis treatment includes genicular artery embolization (GAE) to alleviate knee pain due to arthritis.

 

Below are some patient reviews and testimonials. 

patient patient patient patient patient 18 2

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 


Patient Reviews & Testimonials2023-02-15T15:40:22-08:00

Patient Transformation: Spider Veins

2023-02-15T15:33:59-08:00

What are spider veins?

Spider veins are the fine, thread-like reddish veins at the surface of the skin. These veins are not healthy. Veins 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. Spider veins may also be a sign of underlying venous insufficiency. For example, spider veins 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 of these veins.

What are the symptoms?

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

What causes them?

Spider veins in the legs 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. These 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.

Below you can see the transformation of 3 of our patients who received vein treatment.

spider spider spider

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 


Patient Transformation: Spider Veins2023-02-15T15:33:59-08:00

Patient Transformation: Varicose Veins

2023-02-15T15:30:03-08:00

Varicose Veins: Patient Transformations 

What are varicose veins?

They are the twisted, bulging veins just beneath the surface of the skin. These veins are swollen, twisted veins that you can see just under the surface of the skin. These veins usually occur in the legs, but they also can form in other parts of the body. Varicose veins are a common condition.

What causes them?

Varicose veins are caused by leaky vein valves, which allow blood to pool within the veins causing them to stretch and become enlarged. These veins can be an isolated finding, but the majority of the time, they are caused by underlying venous reflux disease. Venous reflux disease is also known as venous stasis, venous insufficiency or venous incompetence. Reflux may occur in the deep and/or superficial leg veins.

In our study, led by Dr. Nisha Bunke and published in the Journal of Vascular Ultrasound in 2018, we studied over 1,000 legs with varicose veins. Over 90% of the time, the source of the varicose veins were the great and small saphenous veins. The Great Saphenous Vein (GSV) courses up the middle of the thigh and calf and the small saphenous vein (SSV), which courses along the back of the calf. Normally, there are one-way valves within the leg veins, which help blood flow in one direction: toward the heart. This means blood is traveling against gravity. The calf muscle also helps move blood toward the heart. When vein valves are leaky, blood flows backward (reflux) towards the feet. Blood pools in the lower legs, causing bulging veins at the surface. 

As you can see below, these patient transformations after varicose vein treatment are remarkable! 

varicose varicose varicose varicose

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 

 

Patient Transformation: Varicose Veins2023-02-15T15:30:03-08:00

Vein & vascular conditions are not always visible to the naked eye

2023-02-15T15:25:22-08:00

Noninvasive Vascular Laboratory

The Vascular Laboratory at La Jolla Vein & Vascular utilizes advanced, noninvasive, diagnostic, medical ultrasound technology while ensuring high quality results to detect diseases that may affect blood flow in the arteries and veins.  We utilize “state-of-the-art” color duplex ultrasound imagers and indirect testing equipment.

The Vascular Lab offers the convenience of:

  • Non-invasive testing
  • Same-day imaging appointments
  • Follow-up clinic visits with our on-site vascular team
  • Appointments at multiple locations including La Jolla, Poway, Chula Vista, and Solana Beach.

What is Duplex Ultrasound

vein

Duplex ultrasound involves using high frequency sound waves to look at the speed of blood flow, and structure of the blood vessels. The term “duplex” refers to the fact that two modes of ultrasound are used, Doppler and B-mode. The B-mode transducer obtains an image of the vessel being studied. The Doppler probe within the transducer evaluates the velocity and direction of blood flow in the vessel.

Types of Ultrasound Testing Offered:

Direct testing (duplex imaging)

Venous

Arterial

vein

  • Abdominal Aorta
  • Abdominal Aortic Aneurysm (AAA) Screening- must meet criteria of SAAAVE Act
  • Carotid Duplex
  • Lower Extremity Duplex

Indirect testing (non-imaging)

vein

Who Performs the test?

Accuracy is critical. Our ultrasounds are ALWAYS be performed by a credentialed sonographer, called a Registered Vascular Technologist (RVT). An RVT is a sonographer who completed a two-year ultrasound program, plus additional clinical training and obtained certification by meeting the highest standards by The American Registry for Diagnostic Medical Sonography® (ARDMS®).  It is important that a specially trained RVT perform the study, because a special protocol must be followed for each study to meet accreditation standards.  The protocol involves taking images at certain anatomic locations using special waveforms to show blood flow. All images taken by the RVT are reviewed by the physician.

Learn More About Testing

Deep Vein Thrombosis (DVT) Ultrasound

Venous ultrasound uses sound waves to produce images of the veins in the body. It is commonly used to search for blood clots, especially in the veins of the leg – a condition often referred to as deep vein thrombosis. Ultrasound does not use ionizing radiation and has no known harmful effects.

Venous Reflux Ultrasound

Ultrasound looks at deep and superficial veins in the legs to check for 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, skin changes, patients who have failed prior treatment, patients who are symptomatic and in some patients with certain anatomic patterns of spider veins. Up to 40 million Americans have varicose veins. Left untreated, the veins may become worse.

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.

Carotid Artery Ultrasound

Ultrasound evaluation of the carotid arteries that screens for buildup of fatty plaque — one of the leading causes of strokes. Carotid arteries are the main blood vessels to the brain. They can develop a buildup of plaque caused by atherosclerosis, or hardening of the arteries. When the buildup becomes very severe, it can cause a stroke. A stroke occurs when part of the brain is damaged by these vascular problems; in fact, 80 percent of strokes are “ischemic strokes” where part of the circulation to the brain is cut off, usually due to blockages in the carotid arteries. The process is similar to the buildup of plaque in arteries in the heart that causes heart attacks. Strokes are the third leading cause of death in the United States according to the National Center for Health Statistics.

Peripheral Arterial Disease Testing

This test uses ultrasound and blood pressure measurements to check for peripheral arterial disease (plaque build-up) in the lower extremities. If you get leg cramps when you walk, it may be a sign of PAD. Learn more about keeping your legs healthy. Peripheral arterial disease (PAD) occurs when atherosclerosis, or hardening of the arteries, causes a buildup of plaque in the blood vessels that carry oxygen and nutrients to all the tissues of the body. As these plaques worsen, they reduce essential blood flow to the limbs and can even cause complete blockages of the arteries. Early on, PAD may only cause difficulty walking, but in its most severe forms, it can cause painful foot ulcers, infections, and even gangrene, which could require amputation. People with PAD are three times more likely to die of heart attacks or strokes than those without PAD.

Abdominal Aortic Aneurysm

The abdominal aorta serves the entire lower half of the body.

Abdominal Aortic Aneurysm (AAA) is an enlargement or “bulge” that develops in a weakened area within the largest artery in the abdomen. The pressure generated by each heartbeat pushes against the weakened aortic wall, causing the aneurysm to enlarge. If the AAA remains undetected, the aortic wall continues to weaken, and the aneurysm continues to grow. Eventually, the aneurysm becomes so large, and its wall so weak, that rupture occurs. When this happens there is massive internal bleeding, a situation that is usually fatal. The only way to break this cycle is to find the AAA before it ruptures. Nearly 200,000 people in the U.S. each year are diagnosed with an AAA, which can be deadly without treatment

 

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 


Vein & vascular conditions are not always visible to the naked eye2023-02-15T15:25:22-08:00

31, 3, 2023

Patient Transformation: Spider Veins

2023-02-13T17:46:30-08:00

What are spider veins?

Spider veins are the fine, thread-like reddish veins at the surface of the skin. These veins are not healthy. Veins 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. Spider veins may also be a sign of underlying venous insufficiency. For example, spider veins 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 of these veins.

What are the symptoms?

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

What causes them?

Spider veins in the legs 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. These 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.

Below you can see the transformation of 3 of our patients who received vein treatment.

 

spiderspiderspider

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 


Patient Transformation: Spider Veins2023-02-13T17:46:30-08:00

Patient Transformation: Varicose Veins

2023-02-13T17:42:40-08:00

Varicose Veins: Patient Transformations 

What are varicose veins?

They are the twisted, bulging veins just beneath the surface of the skin. These veins are swollen, twisted veins that you can see just under the surface of the skin. These veins usually occur in the legs, but they also can form in other parts of the body. They are a common condition.

What causes them?

Varicose veins are caused by leaky vein valves, which allow blood to pool within the veins causing them to stretch and become enlarged. These veins can be an isolated finding, but the majority of the time, they are caused by underlying venous reflux disease. Venous reflux disease is also known as venous stasis, venous insufficiency or venous incompetence. Reflux may occur in the deep and/or superficial leg veins.

In our study, led by Dr. Nisha Bunke and published in the Journal of Vascular Ultrasound in 2018, we studied over 1,000 legs with the veins. Over 90% of the time, the source of the varicose veins were the great and small saphenous veins. The Great Saphenous Vein (GSV) courses up the middle of the thigh and calf and the small saphenous vein (SSV), which courses along the back of the calf. Normally, there are one-way valves within the leg veins, which help blood flow in one direction: toward the heart. This means blood is traveling against gravity. The calf muscle also helps move blood toward the heart. When vein valves are leaky, blood flows backward (reflux) towards the feet. Blood pools in the lower legs, causing bulging veins at the surface. 

As you can see below, these patient transformations after treatment are remarkable! 

 

varicose 54 BA VV varicose DSCF9790 fotor varicose varicose

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 


Patient Transformation: Varicose Veins2023-02-13T17:42:40-08:00

What you need to know about non healing ulcers and wounds

2023-02-13T17:14:53-08:00

We might all be familiar with ulcers in a general manner, but certain types of ulcers behave quite differently due to various contributing factors. These are nonhealing ulcers or nonhealing wounds, and if not treated with care and in good time, such wounds can pose a serious risk to the patient’s health. Severe cases may lead to amputation of the affected limbs or loss of life in the most extreme circumstances. The nonhealing ulcers cases we treat here at La Jolla Vein & Vascular fall under peripheral arterial disease (PAD) and a subcategory of arterial disease.

Non-healing wounds or ulcers do not follow the usual healing process and are referred to as chronic wounds should they persist beyond 3 weeks. Such wounds can be a heavy burden to live with for anyone. Still, the board-certified vascular surgeons and specialists at La Jolla Vein & Vascular are dedicated to administering effective treatment and management solutions to all patients so they may resume a healthy, productive, and pain-free life.

Causes of Non-Healing Wounds

The underlying factors contributing to the risk of developing a non-healing ulcer or wound are widely varied. What they have in common is their ability to interfere with the way the body normally functions with regard to wounds.

Symptoms of Non-Healing Ulcers

You shouldn’t allow a wound to fester for weeks on end before seeking professional assistance, especially if you fall under one or more of the risk categories we’ve outlined above. The following are some warning signs to look out for:

  • Darkening or bluish discoloration around the wound edges
  • Significant pain around the wound that persists without improvement or progressively grows worse
  • Foul odor or smell emanating from the wound
  • Swelling and redness emanating from the wound and spreading to surrounding skin and tissue
  • Continuous leaking, draining, or weeping from the wound.

Notice that these symptoms are mostly indicative of infection. This is a good measure as it often indicates a failure of the body’s natural mechanisms to deal with the wound through its normal processes. The rapid and timely intervention will be called for to forestall further tissue damage and complications.

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 


What you need to know about non healing ulcers and wounds2023-02-13T17:14:53-08:00

May Thurner Syndrome

2023-02-13T16:52:31-08:00

Have you had a blood clot in the left leg, or recurrent blood clots without a known cause? Do you notice swelling of the left leg? If so, you may be considered for evaluation of May-Thurner Syndrome, which can be a hidden cause for left leg swelling and DVTs. May-Thurner Syndrome is a condition where the right common iliac artery overlies and compresses the left common iliac vein against the lumbar spine. This causes narrowing of the vein in the pelvic region, sort of like a bottle-neck. The narrowing of the vein makes the blood flow more sluggish and prone to blood clots and leg swelling. This variant has been shown to be present in over 20% of the population.

thurner

What Is May-Thurner Syndrome?

The iliac arteries originate from the largest artery in the body, the abdominal aorta. They split at the spine to form the left and right iliac arteries, which feed blood to the pelvis and legs. The right iliac artery is supposed to lie over the left iliac vein, but with this syndrome this artery is compressing the vein. As a result of this compression, the iliac vein narrows and constricts, sometimes scarring. This narrowing results in increased risk of developing blood clots or deep vein thrombosis in that extremity.

Why Do I Have May-Thurner Syndrome?

This condition is congenital but not hereditary and is more common in women than men. It shows up more frequently in young women taking birth control medication, as women age or as they gain weight. Many people may be unaware that they have this disorder, because many may only have some degree of compression of the iliac vein. Only a small number of individuals have severe compression of the iliac vein, resulting in symptoms, namely blood clots in the deep veins of the leg.

How Is May-Thurner Diagnosed?

Diagnosis is achieved by a combination of physical examination and diagnostic testing. Diagnosis may also occur when patients present with symptoms of a deep vein thrombosis (DVT- please see this section of venous conditions) and further testing is completed.

Tests to confirm diagnosis include:

What Are My Treatment Options for May-Thurner Syndrome?

The goal of treatment is to reduce symptoms as well as reduce the risk of further complications.

  • Anticoagulant therapy: These medications thin your blood and prevent the current clot from increasing in size, as well as prevent new clots from forming. These medications do not dissolve the clots that you have. You may be on IV heparin for several days or an injection called Lovenox that is given in the abdomen once daily for 5 to 7 days. You will be started on a medication called warfarin (Coumadin), which is an anticoagulant pill. It can take about 3 days for this medication to have effect, so during that time you may be on both warfarin and heparin. You may be on this medication for up to 6 months, during which time routine blood tests are required to ensure your blood is at the appropriate thinness to prevent clots from forming.
  • Catheter-directed Thrombolytic Therapy: During this procedure, a thin flexible tube called a catheter is inserted into a puncture in the skin and guided into the affected blood vessel of the lung. A thrombolytic drug is injected which dissolves the clot over a period of time. There is a much higher risk of bleeding as well as stroke with this therapy, compared to anticoagulants.
  • Angioplasty and stenting: Once the clot has been removed from the vein, this procedure is performed to widen the compressed vein. A thin flexible tube called a catheter is inserted in a puncture over a vein in the leg. A small balloon at the tip of the catheter is inflated to stretch the iliac vein open, increasing blood flow to the leg. A small metal mesh tube called a stent is inserted through the catheter and guided to the ballooned area of the iliac vein. The stent will help hold the compressed area open and will remain in the vein permanently.
  • Inferior Vena Cava (IVC) filter: During this procedure, a thin flexible tube called a catheter is inserted through a vein in your leg, arm, or neck. The vascular surgeon passes a small special metal filter through the catheter and places it in the inferior vena cava, which is a large vein in your abdomen that carries blood back to the lungs. This filter traps clots that break away from leg veins, preventing them from travelling to your lungs. This is done if the patient cannot tolerate anticoagulation therapy.

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 


May Thurner Syndrome2023-02-13T16:52:31-08:00

informacion en español

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

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