8, 5, 2023

How can you tell your vein disease is worsening?

2023-02-15T18:57:27-08:00

Venous reflux disease is also known as venous stasis, 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 venous stasis 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.

Varicose Veins and Venous Reflux Disease

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.

What causes varicose veins?

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.

 

“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. 


How can you tell your vein disease is worsening?2023-02-15T18:57:27-08:00

17, 2, 2023

Pelvic & Labial Varicose Veins

2023-01-14T13:29:10-08:00

Pelvic & Labial Varicose Veins

Most people understand that varicose veins can be found in the legs and feet. And while this is mostly true, they can also manifest in the vulva. This is generally why most women who develop from vulva varicosities don’t notice it until the condition begins to worsen.

What are Labial Varicosities?

Vulvar varicosities, also commonly referred to as labial varicosities, are a condition when the veins in the labia minora or Majora become dilated.

Like any other part of the human body, the vulva is interconnected through an extensive reach of large and small blood vessels. During pregnancy, the increase in weight and pressure may reduce blood flow to the lower body and genitals. This will then cascade into the condition known as Labial varicosities.

While no one is fully exempt from developing vulvar varicose veins, the condition is more apparent in pregnant women. Moreover, pregnant women are more susceptible to developing pelvic varicosities due to the pressure and weight exerted by the baby.

However, in most cases, the condition does go away after giving birth. Ideally, you should start feeling better within six to eight weeks from the delivery time. Unfortunately, in some women, the dilated veins do not recover independently and need medical intervention to help fix the condition and get you back to your normal self.

Most people understand that varicose veins can be found in the legs and feet. And while this is mostly true, they can also manifest in the vulva. This is generally why most women who develop from vulva varicosities don’t notice it until the condition begins to worsen.

There are numerous veins supplying blood to and from the vulva. And since they all differ in size, there’s no sure way to tell if you’re developing pelvic varicosities. The impact may leave them moderately swollen from the varying size of the veins, especially in the smaller veins. Larger veins may get twisted and become painful over time. This further goes to assert the importance of consulting a healthcare professional if you’re uncertain.

“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. 

Pelvic & Labial Varicose Veins2023-01-14T13:29:10-08:00

25, 1, 2023

Leg Pain: What can be causing it?

2023-01-14T13:07:18-08:00

Concerned about Leg Pain?

We evaluate and treat leg pain that is related to poor circulation, varicose veins and blood clots. These are all vascular conditions. However, there are numerous causes of non-vascular leg pain including injuries in the joints, bones, muscles or ligaments. Arthritis can also cause leg pain. Low back pain can radiate to the legs and also cause pain. It is always important to have a thorough evaluation by your doctor to determine the correct cause.

Causes of Leg Pain

  • Injuries in the joints, bones, muscles, or ligaments
  • Arthritis
  • Low back pain radiating to the legs

“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. 

Leg Pain: What can be causing it?2023-01-14T13:07:18-08:00

Venous Insufficiency and Leg Ulcers

2023-01-14T13:06:34-08:00

What is chronic venous insufficiency?

Chronic venous insufficiency (CVI) is an inflammatory condition caused by long standing, untreated venous reflux disease.  Commonly, venous reflux disease causes a collection of symptoms such as leg swelling, heaviness, fatigue and varicose veins. But, over time, when blood is no longer circulating properly in the leg veins, skin changes can also appear. When skin changes appear, this is termed, chronic venous insufficiency (CVI). Venous stasis is another term used for this condition.   Chronic inflammation from CVI causes the skin around the ankles to darken, become dry, itchy, and firm. In severe cases, the skin can start to break down and ulcerate. The ulcer (wound) occurs in the inner or outer ankle and is also referred to as a stasis ulcer or venous ulcer.

Venous stasis skin changes associated with venous insufficiency include:

  • Darkening of the skin along the ankles
  • Itching and dry skin around the ankles (venous eczema)
  • Development of wounds around the ankles, called venous leg ulcers

HOW IS CVI TREATED?

The treatment of CVI cannot reverse the skin changes but it can prevent it from worsening and ulceration. In our experience, treatment of underlying venous reflux reduces the inflammatory changes and the skin may become less itchy and dry, but the permanent skin discoloration does not disappear. Treatment involves correction of the underlying venous reflux.

HOW ARE LEG ULCERS TREATED?

Venous leg ulcers, depending on the severity, can be healed with a combination of correction of the underlying venous reflux, wound care clinic referral, and compression therapy. A detailed ultrasound will determine what specific treatment is needed depending on where the underlying reflux lies (for example, in the saphenous veins, perforator veins and tributaries). Deep vein reflux is also present in many individuals with ulcers.

“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. 

Venous Insufficiency and Leg Ulcers2023-01-14T13:06:34-08:00

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

26, 12, 2022

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

Varicoceles what you need to know

2022-10-24T12:51:01-07:00

What are Varicoceles?

 

A varicocele is a term used to describe abnormal enlargement of the veins within the scrotum. The veins carry blood from the various body organs back to the heart. Typically, veins have valves that prevent blood backflow. When the valves in the veins within the scrotum don’t work as they should, blood tends to collect in the scrotum, leading to varicoceles.

 

While varicocele is very common, it is not life-threatening. In fact, research shows that about 15 percent of all adult men have varicocele. For most men, the condition will go unnoticed throughout their life or does not cause any complications. Although the condition is not dangerous, varicocele is a common cause of low sperm production and reduced sperm quality, leading to infertility. They can also lead to reduced testosterone production and scrotal discomfort. The condition often does not need treatment until there is a reason for concern about the associated problems. Fortunately, varicocele is easy to diagnose and treat.

 

How do they Affect the Testis?

 

 

 

While numerous theories exist, medical experts agree that they cause the veins to carry warm blood from the abdomen down to the testis. Generally, the testis functions properly at around three degrees below the average body temperature. As such, warmblood can affect the testis’ ability to produce testosterone and sperm.

 

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. 


Varicoceles what you need to know2022-10-24T12:51:01-07:00

Swelling from varicose veins

2022-10-24T12:26:09-07:00

Varicose Veins and Swelling

Leg swelling (is also known as edema), is a common complaint related to varicose veins and underlying venous insufficiency. It can be present simply from underlying venous insufficiency without visible signs of varicose veins or spider veins. As a result, a venous insufficiency study by duplex ultrasound scanning is part of the recommended work-up for this undesirable symptom. The swelling usually affects the ankles.  Most people with vein-related symptoms experience progressive swelling throughout the day, that is worse at night time and improves in the morning (they usually wake up with normal appearing legs in the morning but by night-time, shoes may feel tight.) When it is vein-related, it is worse at the end of the day, with prolonged standing, sitting or with air travel, heat and menstruation.  The degree varies from one person to another.

Compression stockings and leg elevation will help reduce swelling.   If the swelling can be attributed to the varicose veins or venous insufficiency, correction of the underlying vein problem will reduce it.

It is a common symptom of varicose veins and venous insufficiency. The legs often feel heavy. It is common to notice sock lines around the ankles by the end of the day.

Conservative management and lifestyle changes can ease the symptoms of varicose veins and swelling and help reduce complications such as thrombophlebitis (blood clots within veins) and vein rupture, but do not cause the veins to vanish. These measures are helpful if an individual is not a candidate for vein procedures or wishes to delay interventional treatment.

Varicose veins can cause swelling and at La Jolla Vein Care, we offer numerous treatments for our patients. Check out a few of our favorite treatments that help reduce the swelling and varicose veins. Please call our office to schedule a consultation with one of our vein specialists to help in reducing swelling and other varicose vein symptoms.

 

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. 


Swelling from varicose veins2022-10-24T12:26:09-07:00

30, 11, 2022

Your height & varicose veins

2022-10-24T11:41:31-07:00

Does height play a role in developing varicose veins? Yes. We initially presented this information in 2018, after a study at Stanford University School of Medicine found a person’s height to be a significant risk factor for developing varicose veins. “We not only found an association between height and varicose veins, but the genetic studies we did showed a causal link,” said cardiologist and study author Dr. Nicholas Leeper, an associate professor of surgery and cardiovascular medicine at Stanford. “That suggests that the genes and pathways that drive human height are also likely to be causing varicose veins.” The study originally published in 2018, found a significant link between above-average height and vein health. In this population-based study of ~500,00 individuals, greater height appeared as a novel predictor of varicose vein disease in machine learning analyses, and was independently associated in multivariable-adjusted Cox regression.

Other known influences such as age, excess weight, being female, and genetics also play a role in the development of them. This study reveals that taller individuals, the study concluded, have a greater chance of developing them and possibly even blood clots in the legs.

The reason has to do with gravity — blood from the legs of taller people must travel a greater distance to the heart, which forces the veins to work harder. But it also has to do with genetics. The study’s authors found above-average height was not only associated with varicose veins, but could be the underlying cause of the swollen veins that rise to the surface of the legs and feet as well.

Lifestyle modifications to reduce the risk of developing them by including use of compression stockings when traveling and sitting or standing for longer periods of time, exercise, weight loss (if indicated), and leg elevation. Read about measures to reduce symptoms related to varicose veins.

Original Study Published in Circulation.

Clinical and Genetic Determinants of Varicose Veins: A Prospective, Community-Based Study of ~500,000 IndividualsEri Fukaya, Alyssa M. Flores, Daniel Lindholm, Stefan Gustafsson, Daniela Zanetti, Erik Ingelsson, Nicholas J. LeeperCirculation.

 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. 

 

Your height & varicose veins2022-10-24T11:41:31-07:00

What you need to know about venous insufficiency

2022-10-24T11:36:50-07:00

When you become a patient with La Jolla Vein and Vascular, you will go through a screening process, and a vascular evaluation using ultrasound technology to diagnose your venous reflux disease. Chronic venous insufficiency is a disease affecting at least 50 million Americans. It is very common, but unfortunately undiagnosed. Through our venous insufficiency Duplex Ultrasound test, our vein specialists can determine exactly what is going on in the patient’s veins. 

The anatomy and process of venous insufficiency or venous reflux disease: 

One of the major veins that takes the blood to the heart is deep inside the muscles of the thigh and calf called the deep veins. Parallel to this lies the superficial veins inside the legs. Superficial veins dump the blood into the deep vein in the groin area and collectively they take the blood back to the heart. 

The direction of the blood flow begins from the ground up towards the heart. Both deep and superficial have a structure system known as the valves. They function as a safety unit directional valve system. Where the blood can flow upward and not downward and be open or closed off. Similarly the same type of structure is found in your heart with heart valves. 

Over the course of the years, depending on your occupation, family history, pregnancy, surgeries, any trauma or injury to your legs, and any kind of underlying muscular or skeletal problem will contribute to problems with the valves in your legs. The valves, over the course of the years may get farther apart from one another. They will still be able to open and close, but the main problem will be the blood flow will not be able to go in one direction. This causes the veins to become enlarged. As a result,  the valves remain open and the blood to flow upward and also downward. This is known as venous reflux disease or venous insufficiency. 

A consultation with one of our vein specialists for chronic venous insufficiency involves taking a detailed history and physical examination in combination with a venous reflux ultrasound study.  Based on your personal findings, a customized treatment plan will be discussed which may include doing nothing, conservative management, or various treatment options based on your individual needs. 

 

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 you need to know about venous insufficiency2022-10-24T11:36:50-07:00
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