11, 1, 2023

Varicose Veins & Treatment

2022-12-26T11:36:19-08:00

Endovenous laser vein ablation, also known as endovenous laser therapy (EVLA), is a type of treatment for saphenous vein reflux, the underlying cause of most varicose veins. At La Jolla Vein Care, we offer ALL treatment modalities for varicose veins, not just one. Treatment is customized based on a person’s individual pattern of venous reflux (determined by ultrasound examination), personal preference, and personal health history.

EVLA Treatment for Varicose Veins Recovery Tips: 

What should I do to optimize recovery after treatment? 

 

Walking is essential to optimize recovery and avoid pooling of blood in the legs. You should walk 30 minutes twice daily during treatment and to do other calf exercises throughout the day.

 

Thigh-high compression stockings must be worn continuously for 72 hours after each treatment and for an additional week during the day after the last treatment. This improves your recovery and reduces complications.

 

Ice packs can be used as well as anti-inflammatory medications such as ibuprofen (Advil, Motrin) and naproxen (Aleve) for pain relief.

 

No strenuous exercise, hot tubs, or leg massages for two weeks to allow veins to heal.

 

Avoid airline travel for two weeks to minimize risk of deep vein clots.

 

Avoid Saunas as these dilate the superficial veins and interfere with healing.

 

“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.

 

Varicose Veins & Treatment2022-12-26T11:36:19-08:00

Varicose Veins 101

2022-12-26T11:31:21-08:00

Varicose veins are swollen, blue, bulging, twisted, superficial (those closest to the skin) veins of the leg. High pressure inside the superficial veins of the leg causes varicose veins, but genetics are thought to play a large, contributing role. As many as 40 million Americans have them. Left untreated, varicose veins may become worse. Persons with varicose veins often experience leg aches and fatigue. They may also incur skin changes such as rashes, redness and ulcers.

What factors influence development of varicose veins?

  • Age: People between the ages of 30 and 70 often have varicose veins. 
  • During pregnancy, 50 to 55 percent of American women experience varicose veins. In most cases, the veins return to normal within a year after childbirth.
  • Women who have multiple pregnancies may develop permanent varicose veins.  

Risk factors include:

o being overweight, or a family history of varicose veins

o standing or sitting for long periods of time

A vascular surgeon will review your medical history, do a physical exam and look at your prominent veins. You may be sent for a duplex ultrasound test, also known as a venous reflux study, to identify the causes of your varicose veins. The painless test uses high-frequency waves to measure the venous blood flow. The test helps the physician visualize the vein structure and the blood flow in the veins.

Most doctors will suggest lifestyle changes for patients. This includes:

  • maintaining the proper weight
  • elevating legs when resting
  • not sitting or standing for long periods of time 
  • wearing compression (elastic support) stockings

In some cases, a vascular surgeon will recommend additional treatments:

  • Sclerotherapy is the sealing of the veins via an injection of a medication. This procedure is done mainly for smaller spider veins. It is performed in a doctor’s office. The physician injects a chemical into the varicose veins to prevent the veins from filling with blood.
  • Vein Stripping is performed. The physician may make two small incisions, one in the groin area and another below the knee, through which the diseased veins are removed. This is an outpatient procedure, usually done under general anesthesia. Patients can resume their normal activities after four weeks.
  • Ablation and laser treatment are performed on patients with severe varicose veins. They are done under local or general anesthetic. The ablation procedure inserts a thin, flexible catheter into the leg vein. The tip of the catheter has tiny electrodes that heat and seal off the walls of the vein. Laser treatments use a tiny fiber placed in the vein through a catheter. The fiber sends out laser energy that closes the diseased portion of the vein. These two modes of treatment frequently replace stripping of the saphenous vein. They can be performed alone or in conjunction with removal of individual clusters of the veins known as small incision avulsion or ambulatory phlebectomy.

 

“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. 

 

Varicose Veins 1012022-12-26T11:31:21-08:00

Meet our team of vein & vascular specialists: Dr Lucas

2022-12-26T10:58:13-08:00

Our vein and vascular specialists are not your average doctors.  They train and teach other doctors, medical students, physician assistants, and empower and educate patients everyday with knowledge and choices.  They lead clinical research studies and contribute to scientific journal and textbook publications.  Our recent research made the cover of the “Journal for Vascular Ultrasound” in March, 2018.  Our doctors continuously strive to elevate the standard in vein care- they are fellowship-trained, board certified in venous and lymphatic disease, and earned additional credentials in ultrasound interpretation to provide comprehensive vein care for all patients.

 

Sarah Lucas MD, FACS, RPVI

 Vascular Surgeon

vascular

Dr. Sarah Lucas, MD, FACS, RPVI is a board-certified vascular surgeon who has chosen to focus her practice on the care of patients with venous and lymphatic disease. She is also a diplomate of the American Board of Venous and Lymphatic Medicine. She is a graduate of the Duke School of Medicine and the integrated vascular surgery residency of Georgetown University Hospital and Medstar Washington Hospital Center in Washington, DC. She returned to Duke as a faculty member following graduation.She and her husband then relocated to Memphis, Tennessee for his pediatric surgery fellowship. During that time, she was on staff at the Memphis VA Medical Center, where she served as faculty for the vascular surgery fellowship of the University of Tennessee Health Sciences Center.

Dr. Lucas and her husband are delighted to have found their permanent home in San Diego, where he is a pediatric surgeon at the Naval Medical Center.

Dr. Lucas has authored numerous peer-reviewed publications and a book chapter in the field of vascular surgery. She is active in the Society for Vascular Surgery and a member of the Young Surgeons’ Committee. Dr. Lucas joined La Jolla Vein Care in 2018. In addition to her role at La Jolla Vein Care, she also manages patients with vascular wounds at the Scripps XIMED wound care clinic.

Dr. Lucas is a Fellow of the American College of Surgeons. Surgeons who become Fellows of the College have passed a comprehensive evaluation of their surgical training and skills; they also have demonstrated their commitment to high standards of ethical conduct.

 

Peer-Reviewed Journals:Dr. Sarah Lucas

 

“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. 

 

Meet our team of vein & vascular specialists: Dr Lucas2022-12-26T10:58:13-08:00

Meet our team of vein & vascular specialists: Dr Bunke

2022-12-26T10:53:06-08:00

Our vein specialists are not your average doctors.  They train and teach other doctors, medical students, physician assistants, and empower and educate patients everyday with knowledge and choices.  They lead clinical research studies and contribute to scientific journal and textbook publications.  Our recent research made the cover of the “Journal for Vascular Ultrasound” in March, 2018.  Our doctors continuously strive to elevate the standard in vein care- they are fellowship-trained, board certified in venous and lymphatic disease, and earned additional credentials in ultrasound interpretation to provide comprehensive vein care for all patients.

 

Nisha Bunke, MD FACPh, RPhS

Venous Disease Interventionist, Vein Clinic Medical Director

vein

Dr. Nisha Bunke was the first physician in the United States to complete fellowship training supported by the American Vein and Lymphatic Society (formerly known as the American College of Phlebology) in 2008 and is a diplomate of the American Board of Venous and Lymphatic Medicine. Over the past decade, Dr. Bunke has dedicated her career to treating patients with venous and lymphatic conditions and advancing the field of vein care.

Being inspired by her mentor, world-renowned vascular surgeon, Dr. John Bergan, who emphasized that venous disease is a special condition that requires specialized care, she founded La Jolla Vein Care in 2010. Under her leadership, La Jolla Vein Care was awarded accreditation in Vein Clinic and Vascular Testing by the Intersocietal Accreditation Commission (IAC). La Jolla Vein Care is the first dedicated vein care facility in the region to earn this distinction.

Prior to turning her complete attention to La Jolla Vein Care, she has held appointments as a Volunteer Clinical Instructor of Surgery at the University of California San Diego (UCSD) School of Medicine, and Veterans (VA) Medical Center.  In addition to these duties, for five years, Dr. Bunke managed the vein clinics at the VA Medical Center La Jolla, providing vein care for our veterans.  She was also a physician at UCSD Healthcare System’s Department of Vascular Surgery, where she evaluated and treated patients with venous disease.

Dr. Bunke is a physician and scientist, actively leading clinical research studies.  In 2009, Dr. Bunke was awarded the International Union of Phlebologie Research Fellowship and the Best Young Presenter Award in Monaco.  Collectively, Dr. Bunke and Dr. Bergan were awarded the 2008 JOBST Research Award for the Advancement of Phlebology for their research on Inflammatory Biomarkers of Venous Insufficiency. Dr. Bunke also developed Recova, a post-surgery recovery cream.

Dr. Bunke has been named as a finalist by the San Diego Business Journal’s Women Who Mean Business Award and San Diego Magazine’s Woman of the Year award.  In 2018, she was named as the top 25  Women of the Year by the San Diego Business Journal.

Dr. Bunke’s Affiliations

Moreover, Dr. Bunke is a member of the Scripps Ximed Medical Group, The Clinical and Translational Research Institute (CTRI) of the University of California San Diego (UCSD), the American Medical Association (AMA), San Diego County Medical Society, Society for Vascular Medicine, American Vein and Lymphatic Society, American Venous Forum (AVF) and the Society for Vascular Ultrasound (SVU). Dr. Bunke has numerous publications in both scientific journals and medical textbooks.

Dr. Bunke is co-editor of the most widely used textbook for vascular physicians, “The Vein Book”

vein

Books/ Book Chapters: Dr. Nisha Bunke

Bergan, JJ, Bunke, N. “Outcome Measures in Venous Disease.” In:  Fast Facts- Vascular and Endovascular Surgery Highlights 2008-09.  Davies, A., Mitchell, A. M. Health Press UK

Bergan, JJ. Bunke, N.  “Varicose Veins and Chronic Venous Insufficiency.” In: Total Endovascular Series Venous Diseases Contemporary Management.’ Lumsden, A, Davies, M.

Bergan, JJ, Bunke, N.  “Venous Disorders.”  In:  Educational Review Manual in General Surgery. 8th Edition. Castle Connolly Graduate Medical Publishing.

Bergan, JJ, Bunke, N. “Pathophysiology of Chronic Venous Disease.”  In:  The European Venous Course Book.

Bergan JJ, Bunke, N. “Endovenous Procedures in Venous Disease.”  In:  Peripheral Endovascular Interventions.  White, R, Fogarty, T.  3rd Ed.

Bergan, JJ, Pascarella, L, Bunke, N. “Venous Anatomy, Physiology and Pathophysiology.”  In: Treatment of Leg Veins, 2nd ed.  Alam, M., Silapunt, S. Martin Mellor Publishing Ltd. UK

Bergan, J. Lee, BB, Bunke N.  “Lymphatic Disease.”  In: Clinical Review of Vascular Surgery. Edited by Sapan Desai, MD, PhD and Cynthia Shortell, MD.

Bergan, J. and Bunke, N. General Considerations. In: Lymphedema: A Concise Compendium of Theory and Practice. Edited by Byung-Boong Lee, John Bergan, Stanley G. Rockson 2011.

Bergan, JJ, Bunke-Paquette, N, editors. The Vein Book, 2nd edition. Oxford University Press, New York, NY USA. 2014

Bunke-Paquette, N. “Complications of Liquid Sclerotherapy.” In: The Vein Book, 2nd ed. Bergan, JJ, Bunke-Paquette, N. Oxford University Press, New York, NY USA. 2014

Loerzel, N, Ratcliff V, Bunke-Paquette, N, et al. “Ultrasound Examination of the Patient with Primary Venous Insufficiency.” In: The Vein Book, 2nd ed. Bergan, JJ, Bunke-Paquette, N. Oxford University Press, New York, NY USA. 2014

Bunke-Paquette, N, Loerzel, N, Bergan, JJ. “Ultrasound-Guided Catheter and Foam Therapy for Venous Insufficiency.’ In: The Vein Book, 2nd ed. Bergan, JJ, Bunke- Paquette, N. Oxford University Press, New York, NY USA. 2014

Bergan, JJ, Pascarella, L, Bunke-Paquette, N. “Perforating Veins.” In: The Vein Book, 2nd ed. Bergan, JJ, Bunke-Paquette, N. Oxford University Press, New York, NY USA. 2014

Bunke-Paquette, N. Russell, T, Broder, K, Li, A. “Medical Management of the Venous Leg Ulcer.” In: The Vein Book, 2nd ed. Bergan, JJ, Bunke-Paquette, N. Oxford University Press, New York, NY USA. 2014

Peer-Reviewed Journals

Bunke N, Brown K, Bergan J. Foam sclerotherapy: techniques and uses. Perspect Vasc Surg Endovasc Ther. 2009 Jun;21(2):91-3

Bunke N, Brown K, Bergan J. Phlebolymphemeda: usually unrecognized, often poorly treated. Perspect Vasc Surg Endovasc Ther. 2009 Jun;21(2):65

B.B. Lee, M. Andrade, P.L. Antignani,F. Boccardo, N. Bunke, et. al. Guidelines: Diagnosis and treatment of primary lymphedema consensus document of the international union of phlebology (IUP)-2013. International Angiology. 2013 Dec: (32): 541-574

“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. 


Meet our team of vein & vascular specialists: Dr Bunke2022-12-26T10:53:06-08:00

La Jolla Vein & Vascular Health Mission

2022-12-26T10:53:29-08:00

Expert Healthcare

Our clinical staff consists of Registered Vascular Technologists (RVTs), Nurse Practitioners and Medical Assistants and ancillary staff who have several years of experience in vein and vascular care and health. Most of our staff have helped patients at La Jolla Vein & Vascular for 5+ years.  We also have administrative staff with expertise in insurance preauthorizations, and in combination with our doctors, will fight for patients to get the treatment they need.

Because of our staff's extensive experience in vein health & care, they are knowledgeable about vein conditions and treatment and are happy to answer questions any time.

health

La Jolla Vein & Vascular Health Values

OUR MISSION

OUR MISSION IS TO PROVIDE OUR EXPERTISE AND SPECIALIZED TRAINING TO IMPROVE YOUR VASCULAR HEALTH, IN A ONE-STOP CONVENIENT SETTING.  OUR COMPREHENSIVE VEIN CARE AND VASCULAR CLINIC HELPS PATIENTS TAKE CONTROL OF THEIR VASCULAR HEALTH.

"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. 

health

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. 

La Jolla Vein & Vascular Health Mission2022-12-26T10:53:29-08:00

28, 12, 2022

What is PAD (Peripheral Arterial Disease)?

2022-10-24T15:03:43-07:00

What is Peripheral Arterial Disease?

Peripheral Arterial Disease is a disease we see and treat at La Jolla Vein and Vascular. You probably are familiar with the terms angina and heart attack, which are related to a blockage of blood flow to the heart. That same sort of blockage can occur elsewhere in the body, depriving the limbs (the peripheral parts of the body) of oxygen and nutrients. Left untreated, the disease can lead to amputation.

Healthy peripheral arteries are smooth and unobstructed, allowing blood to freely provide the legs with oxygen, glucose and other nutrients. As we age, peripheral arteries build up plaque, a sticky substance made up mostly of fat and cholesterol. Plaque narrows the passageway within the arteries and causes them to become stiff, which then leads into peripheral arterial disease. 

A moderate blockage in one of arteries in a major leg muscle, such as the calf or thigh, can cause pain when walking.This pain can be temporarily decreased with rest, but will act up again with more walking or activity.

Lower extremity pain, similar to angina, is called claudication by medical providers. The pain itself is not limb-threatening but it is a sign that the person should make lifestyle changes and see a doctor. 

Examples of possible treatments for peripheral arterial disease include: 

  • Smoking cessation 
  • Daily exercise
  • Medical management

If the disease becomes more severe, the limb can be starved of basic nutrients and the patient begins to suffer pain at rest (especially at night). Sores that won't heal may develop on the feet. This is a very concerning sign for losing toes or even amputation of the leg. An urgent referral to a vascular surgeon is necessary to prevent limb loss in this situation.

Causes and risk factors of Peripheral Arterial Disease:

  • Age
  • Gender—males are more prone to the condition than females
  • Hypertension (high blood pressure) 
  • Diabetes
  • Smoking
  • High cholesterol
  • Obesity
  • Lack of exercise
  • Family history of vascular problems

Leg pain does not always indicate PAD, but older patients, especially those who are at risk, should see a physician. A simple, noninvasive ultrasound and leg blood pressure examination can diagnose peripheral arterial disease and determine its severity.

If you experience symptoms of peripheral arterial disease, ask your primary care physician to refer you to a vascular surgeon. Vascular surgeons can perform any necessary treatments, including medication management, minimally invasive endovascular angioplasty and stent procedures, and open bypass surgery.

Treatment for Peripheral Arterial Disease:

Depending on the severity of your condition, treatment options may include lifestyle changes, medications, minimally invasive angioplasty/stenting, or open bypass surgery.

 

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. 

What is PAD (Peripheral Arterial Disease)?2022-10-24T15:03:43-07:00

What is Asclera?

2022-10-24T13:02:52-07:00

What is polidocanol (Asclera)?

A variety of sclerosant medications can be used for veins, but at La Jolla Vein Care, 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. Asclera (polidocanol) Injection is a prescription medicine that is used in a procedure called sclerotherapy to remove unwanted veins on your legs. It is administered by a healthcare provider to treat two types of veins:

Uncomplicated spider veins (very small varicose veins ≤ 1 mm in diameter)

Uncomplicated small varicose veins (1 to 3 mm in diameter) known as reticular veins

Asclera has not been studied in varicose veins more than 3 mm in diameter. La Jolla Vein Care providers have extensive experience with foam sclerotherapy.

Patient Results before and after at 26 weeks after last treatment

The patient was treated for uncomplicated spider veins (≤ 1 mm)

Treated with 0.5% Asclera

ADVERSE REACTIONS:

-Injection site hematoma

-Injection site irritation

-Injection site discoloration

-Injection site pain

-Injection site itching

-Injection site warmth

-Neovascularization

-Injection site clotting

How often do I need treatment to see results?

The number and frequency of treatments depends on the size of the vessels and their location. Ask your provider about an individualized treatment approach that is right for you.

How does Asclera work?

Asclera is a sclerosing agent that is injected into the vein. It works by damaging the endothelium, the inside lining of blood vessels. This causes blood platelets and cellular debris to attach to the lining of the vessels. Eventually, cellular debris and platelets cause the blood vessel to clot. Over time, the clotted vein will be replaced with tissue.

How satisfied are patients who use Asclera?

88% of clinical study patients were satisfied or very satisfied with their Asclera treatment after 12 weeks.

How long is each Asclera session?

A typical session lasts 15 to 45 minutes. Generally, 1 to 3 injections may be necessary to treat a given spider or reticular vein. Repeat treatment sessions may be necessary. Any additional treatment sessions are usually separated by 1 to 2 weeks.

What should I expect after being treated with Asclera?

Following treatment, you’ll need to wear compression stockings day and night for 2 to 3 days, then for 2 to 3 weeks during the daytime, as directed by your provider. Compression stockings are designed to apply pressure to your lower legs, helping to maintain blood flow, and reduce discomfort and swelling. Compression helps your legs heal and is necessary to reduce the risk of deep vein thrombosis.

Are there activities I should avoid after receiving an Asclera Injection?

For 2 to 3 days following the treatment, avoid:

-Heavy exercise

-Sunbathing

-Long plane flights

-Hot baths, hot tubs, or saunas

Possible side effects to Asclera treatments:

Temporary side effects may occur at the site of the injection, including:

-Bruising

-Raised red areas

-Small skin sores

-Darkened skin in the form of lines or spots

-Multiple tiny red blood vessels

-These side effects usually go away within a few days to several weeks. Some side effects may take months or years to resolve.

For more information or to book an appointment for Asclera therapy, please call our office at 858-550-0330.

 



What is Asclera?2022-10-24T13:02:52-07:00

Vein health & non healing wounds and ulcers

2022-10-24T12:59:46-07:00

Non-Healing Ulcers &  Wounds

We might all be familiar with non healing ulcers & wounds in a general manner, but certain types of ulcers behave quite differently due to various contributing factors. These are non healing ulcers or non healing 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.

Types of Non-Healing Ulcers

In general, patients will present with one of three categories of non-healing ulcers, with these categories being broadly defined by the major causative factors allowing for their development. These are:

Arterial or Venous Ulcers

These are found to account for between 70% up to 90% of non-healing wounds or non-healing ulcers. Mostly occurring in elderly patients, they are believed to come about as a result of a failure of the valves in a person’s blood vessels of both arteries and veins. These valves are responsible for preventing the backflow of blood as it passes within them. The consequent outcome is a lack of nutrient and oxygen-rich blood from reaching the affected tissues and sets up the conditions favoring non-healing wounds.

Pressure Ulcers

These are ulcers that are brought about by the restriction of blood flow to certain regions of the body due to the persistent and prolonged application of pressure upon them. It is mostly encountered among patients with full or partial paralysis and those who are bedridden for extended periods.

Diabetic Ulcers

These are also highly prevalent chronic wounds, and are on the increase among patients owing to the ever-increasing cases of diabetes among the population. In fact, the prevalence of chronic wounds among diabetics makes this demographic 15% more likely to have to undergo limb amputation as a complication of the condition.

The high amputation rate among diabetics is attributable, in part, to the neuropathic effects of the ailment. Neuropathy leads to a lack of pain perception in the affected individual, meaning that they may be entirely unaware of minor wounds on their feet and legs in good time, allowing for their infection or repeat injury. It is also made more likely by the immunosuppressive effects of the condition, which makes the patient more vulnerable to infection.

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. 

 

Vein health & non healing wounds and ulcers2022-10-24T12:59:46-07:00

Vascular Health and Physical Activity

2022-10-24T12:56:53-07:00

Physical activity helps to burn calories, increase the heart rate, and keep blood flowing at a healthy rate for your vascular health. 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

 

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. 

 

Vascular Health and Physical Activity2022-10-24T12:56:53-07:00

Varicose Veins Patient Transformation

2022-10-24T12:54:28-07:00

What are varicose veins?

Varicose Veins are the twisted, bulging veins just beneath the surface of the skin. They 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, and are very common. 

 

Varicose veins are caused by leaky vein valves, which allow blood to pool within the veins causing them to stretch and become enlarged. They 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.

What are the symptoms?

The symptoms can include:

  • Aching, tenderness
  • Heaviness, fatigue
  • General restlessness in the legs
  • Burning pain
  • Throbbing pain
  • Itching
  • Leg cramps, particularly at night
  • Ankle swelling
  • Skin discoloration at the ankle
  • Skin ulcers above the ankle

Over time, complications can develop from untreated veins. These include:

  • Superficial phlebitis (painful inflammation of the vein)
  • Superficial thrombophlebitis (blood clots within the varicose veins)
  • Spontaneous vein hemorrhage (the vein can rupture spontaneously)
  • Skin discoloration and eczema around the ankle (venous eczema)
  • Skin sores or ulcers usually near the ankle

Duplex ultrasound technology is used to evaluate the veins beneath the surface of the skin. The ultrasound allows us to see if the valves are leaky; it can detect the direction of blood flow and also detects blockages in the veins, for example from blood clots or scars within the veins from previous clots. The ultrasound will determine exactly which veins are ‘bad’ or incompetent. Reflux may be detected in the deep veins (within the muscle), the great and small saphenous veins, and/or branches of the saphenous veins. This will help determine the treatment plan.

La Jolla Vein Care Before and After Transformations:

At La Jolla Vein Care, we are here for our patients from beginning to the end. We love seeing the transformations that take place. Below are a few cases from our patient transformations from before varicose vein treatment to after vein treatment. 

 

 

 

varicose varicose varicose

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. 


Varicose Veins Patient Transformation2022-10-24T12:54:28-07:00
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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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