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25, 3, 2022

What to expect when you receive Foam Sclerotherapy

2022-03-25T12:49:38-07:00

Ultrasound-Guided Foam Sclerotherapy

 

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

 

Foam treatment of varicose veins is not as new as people think. It was originally described as early as 1944.  Foam sclerotherapy is a method for treating varicose veins. It involves injecting a foamed sclerosant medication into unhealthy varicose veins, causing them to eventually dissolve.

image of foam sclerosant

Colleagues in Spain attracted attention of some vein specialists and interest in the use of foam technology in treating venous insufficiency was reawakened. Administration of foamed sclerosant was reintroduced in the early 1990s by Cabrerra, who summarized a broad experience in 1997. By the 1990’s, broad use of diagnostic ultrasound imaging made it possible to monitor foam distribution with ultrasound scanning. Some 40 years earlier, and before the development of ultrasound scanning, foam had been used in Germany to treat varicose veins.  At that time, foam was made by special syringes and its distribution was assessed by touch, instead of ultrasound scanning.

foam

How many treatments will I need?

 

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

 

What should I expect on my treatment days?

You will sign your consent form then change into shorts provided by the office. We will clean your skin with alcohol, then use ultrasound to localize the veins. The foam medication will then be injected into your veins with a fine needle. You will elevate your legs on a wedge pillow for approximately 15 minutes. After your foam sclerotherapy treatment, we will help you into your compression stockings, then you will walk for 30 minutes prior to getting in your car. This is normal for your legs to be achy and tender to the touch after treatment. 

For more information on foam sclerotherapy, read this article.

 

What to expect when you receive Foam Sclerotherapy2022-03-25T12:49:38-07:00

What is an abdominal aortic aneurysm (AAA)?

2022-03-24T11:15:19-07:00

What is an abdominal aortic aneurysm (AAA)?

The aorta, the largest artery in your body, runs from your heart, down through your chest, and into your abdomen. The abdominal region of the aorta is responsible for delivering blood to your legs, GI tract and kidneys.

An abdominal aortic aneurysm (AAA) occurs when the wall of the aorta progressively weakens and begins to bulge. An AAA may continue to enlarge and eventually rupture if left untreated, causing severe internal bleeding and possibly death. Nearly 200,000 people in the United States are diagnosed with A A A annually; approximately 15,000 die each year from a ruptured AAA.

In addition to concerns about rupture, clots or debris may also develop within an AAA. These substances can be carried to other areas in the body and block circulation, causing severe pain or possibly limb loss if blood flow is cut off for too long.

AAA can be safely treated with early diagnosis; however, most patients have no symptoms.

Causes and Risk Factors:

Most aortic aneurysms are caused by a breakdown in the proteins that provide structural strength to the wall of the aorta. Some risk factors that contribute to this structural breakdown include:

  • Age—individuals over 60 years are most likely to develop the condition
  • Gender—males are more prone to the condition than females
  • History of atherosclerosis (hardening of the arteries) • Family history of AAA
  • Smoking
  • High blood pressure

Symptoms:

Most people feel no symptoms, and an abdominal aortic aneurysm is often detected when tests are conducted for other unrelated reasons. Those who do have symptoms commonly describe back pain, pulsations in the abdomen, groin pain or sometimes sores on the feet.

Diagnosis

If an abdominal aortic aneurysm is suspected, you likely will be referred for an abdominal ultrasound, a painless, safe test that can screen for and measure the size of an AAA. Computed tomographic angiography (CTA) can assess aneurysm size, location and the extent of impact. This study requires exposure to radiation and injection of an intravenous contrast agent. However, a CTA provides valuable anatomic information and can help your vascular surgeon determine the optimal type of repair.

Medicare Screening Benefit

Medicare offers a free, one-time AAA ultrasound screening for qualified seniors as part of their Welcome to Medicare physical during the first 12 months of their enrollment. Men who have smoked sometime during their life and men and women with a family history of AAA are eligible for this benefit.

Treatment

Vascular surgeons can determine the best procedure for you, based on the size of your aneurysm and other factors. For smaller AAAs, you may need to make lifestyle changes, such as quitting smoking and lowering blood pressure. You may be prescribed medication. Your surgeon will have you come back for regular checkups to see if the AAA has changed.

For large AAAs, or those that have been increasing in size over time, repair may be carried out either by placement of an endovascular stent graft or by open bypass grafting.

Be sure to see a board certified vascular surgeon. They have specific training in both minimally invasive and traditional open repairs. The type of repair conducted is very important to long term durability and freedom from rupture.

 

What is an abdominal aortic aneurysm (AAA)?2022-03-24T11:15:19-07:00

What is Vascular Disease?

2022-03-23T11:47:16-07:00

What is Vascular Disease? 

Your body contains an amazing, intricate system of arteries and veins. Arteries bring oxygen-rich blood from the heart to every inch of the body; veins return the blood back to the heart and lungs for more oxygen.

Most people know that heart disease can occur when blood vessels become clogged with plaque and cholesterol, but many are unaware that the same problem, often called hardening of the arteries (or atherosclerosis), can occur in any artery of the body.

Venous problems occur in the veins, often resulting in leg swelling, deep vein thrombosis (blood clots) and chronic leg problems.

Common types of artery disease include:

 

Carotid artery disease and stroke

Carotid arteries in the neck bring oxygen to the brain. Patients who have had a stroke, a transient ischemic attack

(TIA) or have been told they have an abnormal sound in that artery, will be referred to a vascular surgeon for diagnosis and possible treatment.

Aneurysms

Aneurysms are bulges that develop in a weakened part of an artery. While these can occur in the brain, they are most common in the aorta, which is the body’s biggest artery, running from the heart through the abdomen. Aneurysms can also occur in the pelvis or the knee. They can enlarge when the heartbeat pushes against the weakened wall. In the aorta and pelvis, ruptured aortas can be fatal.

Peripheral arterial disease (PAD)

Patients with hardening of the arteries start to lose blood flow to the limbs. Early on, this may cause pain when walking, but as the disease progresses, 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.

Common Vascular Disease Problems: 

 

  • Varicose veins which are often cosmetic, but can also be a sign of a more serious venous disease.
  • Chronic venous insufficiency is a potentially painful condition that is caused by blood reflux or clotting.
  • Deep vein thrombosis a blood clot in a deep leg vein.

 

Who are Vascular Surgeons:

 

Vascular surgeons train in vascular disease for five to seven years after medical school. Board certified vascular surgeons can treat any vascular condition with any treatment—medication, minimally invasive endovascular surgery, or open surgery. Many vascular conditions are lifelong, and your vascular surgeon may become a lifelong care partner. Be sure to ask to be referred to a board certified vascular surgeon.

 

What is Vascular Disease?2022-03-23T11:47:16-07:00

What are the risks for Microphlebectomy

2022-03-22T12:47:08-07:00

MicroPhlebectomy for varicose veins 

 

A microphlebectomy is a minimally invasive procedure, which is the surgical removal of bulging varicose veins through tiny skin incisions. This procedure is performed in the office with local anesthesia. Phlebectomy is also known as micro phlebectomy (because the incisions are tiny) or it can also be referred to as ambulatory phlebectomy. A microphlebectomy is for someone who is suffering from complications from varicose veins. The complications can include persistent pain, cramping, or discoloration of the skin. 

 

Risks of Microphlebectomy:

With any procedure, there are risks. In microphlebectomy the risks are listed below:

  • There is a low risk of infection at the vein removal sites, which we minimize by using sterile technique and prophylactic antibiotics. You will start the antibiotic on the morning of your procedure and continue it for 24 hours after the procedure. 
  • As with any vein treatment, there are also very small risks of deep vein clots and nerve injury. 
  • You will have bruising where the veins were removed, which fades over about two weeks. To reduce bruising, swelling or redness, try RECOVA cream. 
  • A nerve injury to the skin.
  • Numbness or pain in the feet
  • Adverse reaction to sedative or anesthetic 
  • Severe bleeding or swelling
  • Thrombophlebitis 

 

What are the risks for Microphlebectomy2022-03-22T12:47:08-07:00

After care for Foam Sclerotherapy

2022-03-21T15:15:18-07:00

After care for foam sclerotherapy

After Treatment Care

You will be instructed on how long to wear compression stockings after treatment, depending on the size of the veins that are treated. Most patients wear thigh-high compression stockings continuously for 1-3 days, then another 7 days.

For the first 24 hours after the procedure, you should not get the area wet. But after, you may shower with the stockings on or take a quick cool shower with them off. Avoid heated showers for one week after the foam sclerotherapy treatment.

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

Avoid direct sun exposure during the healing process. The two weeks after treatment. Using sun tan lotion after is recommended.

No swimming in public pools, lakes, or oceans for one week to reduce risk of infection.

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

What to avoid after foam sclerotherapy treatment

For at least two weeks after treatment, you should avoid strenuous exercise (anything more than a brisk walk), heavy lifting, saunas or hot tubs, and leg massages. All of these dilate the superficial veins and interfere with their healing. You should also avoid airline travel for two weeks after treatment.

Possible side effects after foam sclerotherapy treatment

You will likely have some bruising over the injection sites, then the treated veins may become firm and blue. We recommend patients use the product, RECOVA cream, as this helps reduce swelling, redness, and bruising post procedure.

The skin overlying the treated veins may also develop brownish hyperpigmentation as the blood products within those veins are absorbed by the body; in some patients it can take up to a year to fade.

An uncommon complication is a blood clot within a deep vein. The risk is minimized by using ultrasound guidance and performing calf exercises throughout the procedure.

 

After care for Foam Sclerotherapy2022-03-21T15:15:18-07:00

EVLA Treatment for Varicose Veins Aftercare 

2022-03-18T15:37:25-07:00

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.

 

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.

 

We look forward to helping you achieve your treatment goals! 

Please reach us at (858) 550-0330 with any questions. 

 

EVLA Treatment for Varicose Veins Aftercare 2022-03-18T15:37:25-07:00

The Four Best Ways to Treat Venous Disease

2022-03-17T10:25:13-07:00

Symptoms to look for in venous disease:

 

La Jolla Vein Care offers various ways for venous disease treatment. While there are numerous excellent ways to treat venous disease, we have named four of our favorite ways to treat it. What is venous disease and how does it happen? Venous disease occurs when backwards flow (or “reflux”) is present in the superficial veins of the legs. This can cause pain, fatigue, itching, swelling, and varicose veins, which can lead to venous disease. Night-time symptoms include leg cramps and restless legs. Advanced disease can produce skin damage and wounds that do not heal. 

At La Jolla Vein Care, an ultrasound is used to identify the source of backwards flow in the veins and develop a personalized treatment plan. 

The best symptomatic and cosmetic results are achieved when superficial vein reflux is treated from its source, starting with the main superficial veins of the legs and leaving the skin-level (cosmetic) treatment for last. 

 

Each specific treatment plan depends on the patient’s goals. Some patients are only concerned about symptomatic improvement and avoiding complications of long term venous reflux disease. Others may be interested in cosmetic improvement. In either case, we can generally achieve an 80% improvement in symptoms and appearance of the legs. Many patients also report improvement in swelling  after venous disease treatment.  

 

Venous Disease Treatment: Saphenous Vein Reflux with a Catheter Ablation Procedure

 

The great and small saphenous travel down the inner leg and back of the leg, respectively. These veins tend to be straight and far from skin and nerves, which allows us to treat them with minimally invasive catheter procedures that are potent and precise. A catheter is a very thin tube that is inserted into the vein, similar to an IV, through which the doctor can apply heat, a rotating wire, and or medication. All modalities are about 95% effective in closing the diseased vein. None require a skin incision, so they do not leave a scar. 

 

Venous Disease Treatment: Branch Vein Reflux

 

Ultrasound-guided foam sclerotherapy is the most common treatment for branches of the saphenous veins and portions of the saphenous veins which cannot be treated with a catheter procedure (e.g. if they are too close to skin or nerves). The veins are localized with ultrasound, then the medication is given through a tiny needle. Several treatments may be needed, as we can only administer a small amount of foam per day. Large or resistant veins may require more than one injection. For very large bulging varicose veins through tiny skin incisions. This allows many veins to be treated in one day. 

 

Venous Disease Treatment: Spider Veins with Cosmetic Sclerotherapy 

 

Following treatment of the “underlying reflux” with the ultrasound-guided procedures, you may still have some prominent veins at the skin level. These can be treated with cosmetic sclerotherapy. 

 

Venous Disease Treatment: Compression of Stockings 

 

Prior to approval of treatments for vein disease, insurers require patients to try compression stockings. Medicare requires a 3-month trial of compression supervised by the treating physician. We recommend patients should wear the 20-30 mmHg thigh-high stockings for at least a day before treatment to confirm they fit. 

 

The Four Best Ways to Treat Venous Disease2022-03-17T10:25:13-07:00

What are the adverse effects of Vein treatment?

2022-03-17T10:21:05-07:00

What are the adverse effects of Vein treatment?

Patients generally do very well with vein treatments, all of which have a low risk of complications. Some post treatment effects can include:

 

Aching over the treated veins is normal after vein treatment. This responds well to walking, ice packs, and anti-inflammatory medications such as ibuprofen (Advil, Motrin) or naproxen (Aleve). 

vein treatment pain

Bruising over injection sites is also normal after vein treatment and resolves in about two weeks. 

vein treatment bruise

Hyperpigmentation over a vein can occur from blood pigments that are released as the vein is healing. It is more common in patients with large bulging veins and certain complexions. Hyperpigmentation tends to fade over many weeks after vein treatment if you stay out of direct sunlight. 

deep vein clots

Intravascular hematoma refers to a large varicose vein that becomes firm and tender days to weeks after treatment. This also responds well to ice packs and anti-inflammatory medications. We may also recommend a confirmatory ultrasound and/or offer needle drainage of the trapped blood to alleviate discomfort and minimize skin pigmentation. 

 

Deep vein clots are very uncommon, and usually are limited to patients with poor mobility, advanced age, hormone treatment, and/or genetic tendency for clotting. We monitor all patients with ultrasound throughout treatment so we can detect clots at a very early stage before they cause a symptom. We may recommend surveillance ultrasounds, extra walking, and/or a short course of blood thinners. 

deep vein thrombosis

Numb spot over a treated vein is another uncommon event after radiofrequency or laser vein ablation. This occurs when a branch of a skin nerve gets stunned during the heat treatment. It tends to improve over several weeks. The nerves that control the movement of the leg and foot are located far from the superficial veins. 

 

What are the adverse effects of Vein treatment?2022-03-17T10:21:05-07:00

Why have I been offered an endovenous laser ablation (EVLA) procedure? 

2022-03-17T10:20:32-07:00

Endovenous Laser Ablation for Saphenous Vein Reflux 

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.

The  endovenous laser vein ablation procedure may be offered for backward flow (or “reflux”) in your saphenous vein(s).  The great and small saphenous veins are the two main superficial veins that run along the inner thigh/ calf and the back of the legs, respectively. Some people have anatomic variations where the small saphenous vein in the back of the calf extends to the thigh. Many people also have reflux in their anterior or posterior saphenous veins.

evla

This minimally invasive procedure can be performed in the office in less than 30 minutes and patients return to their usual level of activity the same day.

evla treatment

How does the treatment work?

The skin is numbed with lidocaine, then a tiny wire and the laser catheter are inserted into the vein. The catheter delivers laser 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 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, your leg will be prepped with cleansing solution for the sterile procedure. The doctor will perform an ultrasound to map the vein 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 laser catheter under ultrasound guidance. Your doctor will then use a needle to administer a combination of cool saline and local anesthetic around the vein. This solution numbs the vein and insulates it from the surrounding tissue. Laser energy will then be used to painlessly treat the vein. Once your vein has been treated, we will help you into your compression stocking, which you will wear for 72 hours continuously. You will walk for 30 minutes prior to getting in your car. 

 

Why have I been offered an endovenous laser ablation (EVLA) procedure? 2022-03-17T10:20:32-07:00

How is Venous Reflux Disease Treated?

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

How is Venous Reflux Disease Treated? 

 

Step 1: Identifying the underlying problem

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

radiofreqgraphic

Step 2: Varicose Veins

 

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

 

Step 3: Spider Veins 

 

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

 

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