2, 1, 2023

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

Uterine Fibroids: what you need to know

2022-10-24T12:48:30-07:00

Millions of women around the world are affected by the development of uterine fibroids each year. While it is not a life-threatening condition in itself, the symptoms and potential complications that come with it make it such a pressing medical concern for affected individuals.

As only women will usually possess a uterus, it follows that only women are afflicted by this ailment, which is why gynecologists will often be the first ones to make a definite diagnosis. As with so many medical emergencies, knowing the problem early will greatly increase the chances of beating it, which is why the professionals at La Jolla Vein & Vascular are dedicated to administering reliable, accurate, and entirely effective diagnostics, therapies, and treatments to all clients coming through our doors.

Let’s take a closer look at what exactly we will be dealing with should uterine fibroids turn out to be the issue at hand.

What are uterine fibroids? 

To understand what uterine fibroids are, the first thing one should do is separate the two terms making up the condition. A fibroid is a term to refer to a type of tumor that has ‘muscular’ characteristics. They are also referred to as a leiomyoma and can appear singularly or in formations or in lumps. 

They are known as uterine fibroids since they will appear in the patient’s uterus. Although they are not cancerous in almost all instances, they will range in size from patient to patient, from as small as an apple seed to as large as a grapefruit and beyond, in some unusual instances. 

It is important for all women to be aware of the dangers presented by uterine fibroids, not only owing to the potential harm that the condition might bring about but due to the high rate of prevalence among the female population affected in some way. By the time they are 50 years old, it is estimated between 20 to 80 percent of women will have developed uterine fibroids, with most cases affecting the 40’s to early 50’s. 

Symptoms to look out for: 

Fibroids go undiscovered in most patients due to the lack of symptoms accompanying them, but some patients will experience some symptoms, including:

  • Frequent urination due to pressure being exerted on the patient’s bladder
  • Lower back pain
  • Pain during sexual intercourse
  • Enlargement of the lower abdomen, with severe and extremely rare instances causing the appearance of apparent pregnancy in the patient where none exists
  • Heavy bleeding and/or painful bleeding during periods sometimes resulting in a medically significant depletion of blood in the patient (anemia)
  • Greatly increased risks of complication during pregnancy and delivery, with uterine fibroid patients requiring cesarean sections at six times the average rate.
  • Reproductive health problems such as infertility are very rare outcomes.

 

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. 


Uterine Fibroids: what you need to know2022-10-24T12:48:30-07:00

Muscle Hernia or Varicose Veins

2022-10-24T15:51:59-07:00

Is it a muscle hernia or varicose vein?

 

Muscle hernias of the legs frequently are confused with varicose veins. Patients may present with bulging along the outer part of the shin, that looks like a varicose vein. It may or may not be painful. It goes away with flexing the foot (pointing your toes to your head).  But, to experienced vein care specialists, it is clearly a muscle herniation.

Varicose veins are the twisted, bulging veins just beneath the surface of the skin. Varicose 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.

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

A Muscle herniation is a focal protrusion of muscle tissue through a defect in the deep fascial layer. Anterior tibial muscle is the most commonly affected muscle of the lower extremities because its fascia is the most vulnerable to trauma. Clinically it is characterized by asymptomatic or painful, skin-coloured, soft, subcutaneous nodules of various size depending on the position. The diagnosis is usually made clinically based on its typical manifestations, but ultrasonographic examination is useful for detecting the fascial defect and excluding other conditions caused by soft tissue tumors such as lipomas, angiolipomas, fibromas, schwannomas, or varicosities.

Usually, surgical treatment is not needed, but may be necessary for increasingly painful hernias.

At La Jolla Vein and Vascular, we frequently see muscle herniations that are confused with varicose veins. Using ultrasound technology and a clinical examination, we can make an accurate diagnosis.

 

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. 

 

Muscle Hernia or Varicose Veins2022-10-24T15:51:59-07:00

Treatment for non healing ulcers and wounds

2022-10-24T12:37:24-07:00

Treatment of Non-Healing Wounds & Ulcers

As we’ve seen, there is a very wide range of causes that may contribute to the formation and persistence of non healing ulcers and wounds. It follows that the methods or treatment options at the disposal of healthcare professionals will also be varied. Doctors will discuss the available options with their patients in order to arrive at the best possible options, but the type and severity of the wound will be the decisive point of consideration. These measures include:

Compression Wrapping

Specialized Dressings and Topical Medication

Patient Self-Care and Education

Negative Pressure Therapy (NPWT)

Surgery

Growth Factor Therapy

Debridement (removal of dead tissue)

Compression Wrapping

This involves the application of tightly bound wraps to the affected limbs or regions in order to provide support to the vascular system, which might be operating under lower pressure than it should due to the wearing out of the vascular walls and muscles that support the efficient flow of blood to and fro the tissues that need it.

The doctor will start by doing a thorough physical examination. The doctor will also want to learn about your signs, symptoms, personal health history, risk factors, and family health history. The doctor will ask you several questions regarding your medical conditions, such as diabetes, heart disease, and kidney disease. They will also ask you whether you experience pain or cramps in your leg while walking or exercising.

The doctor will also ask about your family history of PAD and other heart diseases. You will also discuss your smoking habit, either current or in the past. After gathering the information, the doctor will proceed to perform a detailed physical examination. The process involves checking for weak pulses in your leg, listening for poor blood flow in the legs using a stethoscope. The physician will also check for any problems on your legs, such as sores, swelling, and pale skin.

Specialized Dressings and Topical Medication

Technological progress has made it possible to develop special dressing materials made out of smart polymers that work by adjusting their absorptive qualities depending on the hydration levels of the wound area, among other specialized positive actions. Antibiotics may also be employed topically to non-healing ulcers and these help by reducing the bacterial levels present in the wounds in question while maintaining the optimal levels of environmental moisture suitable for wound repair.

ose PAD. This test usually compares the blood pressure in your arm with the blood pressure in your ankle. The doctor usually uses a pressure cuff together with an ultrasound device. Sometimes, the physician may request you to walk on a treadmill and have the doctor take the readings before and immediately after the exercise. The procedure will help the doctor to capture the severity of the narrowed arteries.

Patient Self-Care and Education

There are plenty of measures that patients will be able to implement in the treatment and management if armed with the proper knowledge and aids where required. Regular cleaning and disinfecting of wounds, proper bandage care, manual repositioning of paralyzed limbs, and avoidance of habits that contribute to the incidence or severity of these types of ulcers will be of significant benefit to many.

Negative Pressure Therapy (NPWT)

This treatment method works by pulling away the fluid in the wound that nourishes bacteria by the application of negative pressure. It is also known as vacuum-assisted wound closure for this reason. This action will also reduce tissue swelling and bring up fresh blood and nutrients to the problem area, which assist in the healing processes.

Surgery

In many cases, surgical procedures may be called for to rectify any underlying conditions that might be remedied in this way. Patients with atherosclerosis or blood clots in their vascular system, for example, might undergo surgical procedures to remove these clots or clear built-up cholesterol plaques in their system, thus removing the condition that encourages the formation and persistence of non-healing ulcers.

Growth Factor Therapy

Growth factors refer to the biomaterials generated naturally in our bodies that play the role of replacing tissues as they are damaged or degraded, as in the case of wounds and infections. These factors include epidermal growth factor, insulin-like growth factor (IGF), vascular endothelial growth factor (VEGF), and more. What your medical practitioner will do is introduce or stimulate these factors directly onto the wound in order to speed up the healing and re-growing processes.

Skin Graft Therapy

Skin grafts taken from donors (cadaver, usually) are another option here referred to as allografts. These grafts provide a covering to the wound without integrating with the host body and work by encouraging and providing a structure for the growth of epithelial cells. Severe cases might not be suitable for this intervention, however, and will do better with grafts taken from elsewhere on the patient’s own body.

Debridement (removal of dead tissue)

Debridement more simply refers to the removal of dead or dying (necrotic) tissue from the site. The goal is to minimize the risk or opportunity for infection by eliminating the necessary medium for bacterial growth and proliferation, which such tissue provides. This is an especially relevant measure undertaken in the fight against diabetic non-healing ulcers, as amputation will usually be carried out in cases where infection has progressed past a certain limit.

This is the idea behind the rather outlandish yet scientifically sound application of maggot therapy in the management and treatment of chronic wounds. Here, live, disinfected maggots will be introduced to the wound by a medical professional. Maggots will happily devour necrotic tissue while not touching healthy tissue. This directly leads to a reduction in the bacterial presence in the wound, thus encouraging rapid healing as well as pain and odor mitigation.

La Jolla Vein & Vascular Treatments

The treatment for PAD has two main goals. One is to manage the symptoms, including leg pain, allowing you to resume your normal physical activities. The second one is to top the progression of atherosclerosis in the body

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. 

 

Treatment for non healing ulcers and wounds2022-10-24T12:37:24-07:00

How to know your venous reflux disease is worsening over time

2022-12-13T14:04:49-08:00

Venous reflux disease is also known as venous stasis, chronic venous insufficiency, or venous incompetence. Venous reflux disease refers to ‘leaky valves in the veins of the legs. Reflux may occur in the deep and/or superficial leg veins. The deep veins are those within the muscle; they bring at least 80-90% of the blood from the legs back to the heart. The superficial veins are outside of the muscle and under the skin. The main superficial veins are the Great Saphenous Vein that courses up the middle of the thigh and calf and the small saphenous vein, which courses up 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. Symptoms include leg heaviness, leg fatigue, leg pain, ankle swelling, phlebitis (inflamed and painful veins) , restless legs at night, and night cramps. Venous reflux disease is progressive and worsens over time. Skin changes may also develop, including darkening of the skin around the ankles. The darkening of the skin is sometimes referred to as skin changes. The skin can become dry and itchy (venous eczema). Eventually, the skin can break down causing a wound, called a venous leg ulcer. See the image to better understand the 6 main stages of venous disease. Stage 6 is the open leg wound, known as a venous leg ulcer.

Stage 1. Healthy Veins

Stage 2. Spider Veins

Stage 3. Reticular Veins and Varicose Veins

Stage 4. Venous Nodes – Edema venous insufficiency

Stage 5. Chronic insufficiency

Stage 6. Venous eczema and venous leg ulcers

If you experience any vein disease symptoms, please call our office at (858)-550-0330 to schedule a consultation with one of our knowledgeable doctors at La Jolla Vein and Vascular. 

 

For more information on vein health please check out our Youtube Channel or visit our helpful guide of resources



How to know your venous reflux disease is worsening over time2022-12-13T14:04:49-08:00
Go to Top