3, 5, 2022

Varicose Veins: Patient Transformations Part 2

2022-04-28T14:52:04-07:00

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.

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Varicose Veins: Patient Transformations Part 22022-04-28T14:52:04-07:00

28, 3, 2022

Asclera: A New Treatment For Spider Veins and Small Varicose Veins

2022-12-13T13:26:40-08:00

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

asclerabeforeascleraafter

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.

asclerabeforeafter

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.

ascleragraph
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.

Asclera: A New Treatment For Spider Veins and Small Varicose Veins2022-12-13T13:26:40-08:00

What is Radiofrequency Treatment for Varicose Veins?

2022-03-17T10:17:50-07:00

At La Jolla Vein Care, we use a special procedure called radiofrequency treatment for varicose veins. This treatment uses a radiofrequency energy to heat up the wall of the vein. This treatment is used for varicose veins. Varicose veins develop when valves in the veins are damaged and this causes the veins to bulge or twist and stand out in the legs. Radiofrequency ablation treatment closes off the blood flow in the vein that causes the varicose veins. 

radiofrequency treatment for varicose veins

 

Radiofrequency Ablation for Saphenous Vein Reflux 

Why was I offered an endovenous radiofrequency ablation procedure?

Most patients who are offered a radiofrequency ablation procedure is for backwards flow (or reflux) in the saphenous vein(s). The great and small saphenous veins are the two main superficial veins of the leg. They run along the inner leg and the back of the leg, respectively. This minimally invasive procedure can be performed in the office in less than an hour and patients return to their usual level of activity the same day. 

 

How does the treatment work?

 

The skin is numbed with lidocaine, then a tiny wire and the Closurefast catheter are inserted into the vein. The catheter delivers radio-frequency energy to the vein wall, causing it to seal shut. The remaining healthy veins continue to bring blood back to the heart. 

 

What should I expect on the day of treatment?

 

The procedure is performed with local anesthesia, but many patients elect to use a mild oral sedative (Valium), which is taken after checking in and 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 a 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 radiofrequency catheter. Your doctor will then use a  needle to administer a combination of cool saline and local anesthetic around the vein either in the thigh or calf (depending on which vein is treated). This solution numbs the vein and insulates it from the surrounding tissue. After the numbing solution is applied, the vein is painlessly treated with radiofrequency energy. Once your vein has been treated, we will clean your leg and apply a compression stocking which you will wear for 72 hours continuously. You will walk for 30 minutes prior to getting in your car. 

 

What should I do after 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 will alleviate discomfort and avoid pooling of blood in the legs. Most of the numbing solution around the vein will be absorbed by your body within a few hours, but you may have a small amount of blood-tinged saline leak from your puncture site onto the gauze. In that case, just remove the gauze and roll your stockings back up. 

 

What should I avoid after treatment?

 

For at least two weeks after treatment, you should avoid airline travel to minimize pooling of blood in the legs. 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. 

 

What are the possible adverse effects? 

 

Expect some bruising over the injection sites, which fades over about two weeks. The skin overlying larger varicose veins may also develop some temporary inflammation and/or brownish hyperpigmentation as the blood products within those veins are absorbed by the body. An uncommon complication is a blood clot within a deep vein.

 

Before and After Varicose Vein Treatment 

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What is Radiofrequency Treatment for Varicose Veins?2022-03-17T10:17:50-07:00

The 9 Best Ways to Treat Varicose Veins Without Procedures

2022-03-17T10:12:06-07:00

The 9 best ways to treat varicose veins without procedures: conservative management and self-care.  

 

Conservative Management and Self-Care for Varicose Veins

Conservative management and lifestyle changes can ease the symptoms of varicose veins 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. More common options include:

 

Compression stockings: These elastic stockings squeeze or compress the veins to help circulate blood. The compression stockings prevent blood from flowing backward and pooling in the legs. Compression stockings must be graduated, medical grade compression to be beneficial. TED hose are not adequate to reduce symptoms in venous disease for active patients. Compression stockings come in different strengths and the most common strength for the treatment of varicose veins is 20-30mmhg. Your doctor should advise you which strength of compression stockings you should wear. In patients with peripheral arterial disease (PAD), diabetics, and neuropathies, compression may be contraindicated or lesser strengths of compression may be advised. 

 

Leg elevation: Use leg elevation three or four times a day for about 15 minutes at a time. Even elevating your legs on a step stool or ottoman is beneficial. If you need to sit or stand for a long period of time, flexing (bending) your legs occasionally can help keep blood circulating. If you have mild to moderate varicose veins, elevating your legs can help reduce leg swelling and relieve other symptoms. 

 

Exercise: Exercising is good for your veins because it improves blood flow. Walking, cycling, or swimming are great exercises for vein health. But be sure to check with your doctor before starting any exercise program. 

 

Avoid inactivity: Standing or sitting for long periods of time can aggravate your vein condition. To keep blood moving when you have to sit or stand for long periods, try these tips: at work, take walking breaks and try walking during your lunch hour. While sitting, try flexing your feet up and down 10 times an hour. When standing, raise yourself up and down on your toes or rock back and forth on your heels. 

 

Dietary Supplements: Supplements such as horse chestnut and grape seed extract can help reduce symptoms of venous disease. Vasculera is a prescription medication that may be helpful for some. Always check with your PCP before starting supplements or new medications as there may be side effects. 

 

Dietary Changes and High Fiber Diet: A flavonoid rich diet including berries, and green teas, can reduce inflammation and pain. A high fiber diet can increase abdominal pressure and may be helpful for varicose veins. Make sure to drink plenty of water with your high fiber diet. 

 

Anti-inflammatory Medications: are helpful to reduce pain and inflammation, but check with your doctor first to make sure you don’t have contraindications to using them. Ibuprofen and Advil are common oral anti-inflammatory medications. There are also anti-inflammatory cream or gels that can be applied topically to the painful veins, such as Voltaren gel. 

Ice packs: and heating pads can be applied to tender veins. Ice packs and heating pads can be used in an alternating manner. 

Weight loss or maintaining a healthy weight: Being overweight puts extra pressure on your veins. It’s optimal to manage your weight to reduce extra symptoms and pain. These are the 9 best ways to treat varicose veins with conservative management. 

The 9 Best Ways to Treat Varicose Veins Without Procedures2022-03-17T10:12:06-07:00

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