12, 8, 2022

What you need to know about compression stockings

2022-07-20T13:10:20-07:00

At La Jolla Vein and Vascular, we suggest patients use compression stockings for better vein health. There are a few different types to choose from listed below. But first, knowing the benefits of using compression stockings for your vein health empowers you to decide with your physician which type is best for you. 

Benefits of compression stockings for vein and vascular health: 

  1. Wearing compression stockings or socks places pressure on the veins in the lower legs.
  2. The pressure helps improve blood flow
  3. The pressure helps prevent further spider veins and varicose veins
  4. Compression stockings also relieve leg swelling
  5. Reduces the risk of blood clots in the legs

 

Anti-embolism stockings, also known as TED hoses, are designed specifically for non-mobile patients or those confined to a bed. These are the white stockings used for hospital patients. They are low-cost temporary solutions commonly used for patients in nursing homes and post-surgery to prevent deep vein thrombosis (DVT).

 

Graduated compression therapy provides external support to the vein walls and works in conjunction with the calf muscle pump. Compression stockings improve circulation while helping to minimize and control leg and ankle swelling.

However, for ambulatory (walking patients who are not bed-bound), TED hoses do not offer sufficient support to counter the effects of gravity.  They have not graduated compression and only offer about 8-18mmhg compression. TED hose does not help the symptoms of venous disease and varicose veins. TED hose cannot be used for vein treatment and should not be used for daily support in walking patients.

In comparison, graduated compression stockings are medically therapeutic and designed for people who are mobile. Graduated compression means that they are tightest around the ankle and gradually ease as they go up. These can help reduce the risk of DVT in patients who travel by plane or car and reduce symptoms such as leg swelling (edema), aching, heaviness, fatigue, pain from varicose veins, and useful for pregnant women to reduce pain from varicose veins.

 

 For more information and to book a consultation, please give our office a call at 858-550-0330. 

 

For more information 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 compression stockings2022-07-20T13:10:20-07:00

What you need to know about leg ulcers

2022-07-19T18:05:28-07:00

A leg ulceration is the most severe form of chronic venous insufficiency.  This is referred to as a ‘venous leg ulcer.’  Venous leg ulcers make up 70% of all chronic leg wounds.  Therefore, a venous leg ulcer is much more common than a diabetic or arterial ulcer.  It is caused by long-standing pressure within the leg veins, resulting from 1) venous reflux through faulty valves, 2) a blockage within the deep veins or 3) from the inability to use the calf muscles or a combination.  Venous reflux is the most common cause of a venous leg ulcer.  The increased pressure within the leg veins (we call this venous hypertension) causes an inflammatory response. Inflammation then causes changes in the skin, usually around the ankles (this is where pressure is the greatest).  The inflammatory process will cause the skin around the ankles to become brown or discolored, and eventually, the skin will break open.  The leg wound can be healed by treating the underlying vein condition.  Venous leg ulcers can also be prevented by early intervention with non-invasive procedures.  If you have signs of chronic venous insufficiency (such as skin discoloration around the ankles) you should address your underlying vein condition to prevent the skin from breaking open.

 

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 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.

 

 

For more information 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 leg ulcers2022-07-19T18:05:28-07:00

Swelling & Varicose Veins

2022-07-19T17:52:04-07:00

Complications of Untreated Varicose Veins and Venous Insufficiency: Swelling of the Ankles/legs

 

Leg swelling (swelling is also known as edema), is a common complaint related to varicose veins and underlying venous insufficiency. Leg swelling 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. 

 

The Duplex Ultrasound involves using high frequency sound waves to look at the speed of blood flow, and structure of the blood vessels. The term “duplex” refers to the fact that two modes of ultrasound are used, Doppler and B-mode. The B-mode transducer obtains an image of the vessel being studied. The Doppler probe within the transducer evaluates the velocity and direction of blood flow in the vessel.

 

This usually usually affects the ankles. Most people with vein-related experience progressive swelling throughout the day, that is worse at night time and improved in the morning (they usually wake up with normal appearing legs in the morning but by night-time, shoes may feel tight.) Vein-related swelling is worse at the end of the day, with prolonged standing, sitting or with air travel, heat and menstruation. The degree of swelling varies from one person to another.

 

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.

 

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 swelling.

 

For more information check out our website resources and to book a consultation, please give our office a call at 858-550-0330. 

For more information please check out our Youtube Channel at this link. 

 

Swelling & Varicose Veins2022-07-19T17:52:04-07:00

Restless Leg Syndrome and Venous Insufficiency

2022-07-19T17:36:34-07:00

Varicose veins and venous insufficiency are neglected causes for restless leg syndrome.  Restless legs syndrome (RLS) is a neurological disorder characterized by throbbing, pulling, creeping, or other unpleasant sensations in the legs and an uncontrollable, and sometimes overwhelming, urge to move them. Symptoms occur primarily at night when a person is relaxing or at rest and can increase in severity during the night. Moving the legs relieves the discomfort. Often called paresthesias (abnormal sensations) or dysesthesias (unpleasant abnormal sensations), the sensations range in severity from uncomfortable to irritating to painful.

 

RLS is often felt to be a neurological problem that is treated with medication, but there are other causes such as thyroid disease, anemia, pregnancy, and varicose veins. RLS is actually common amongst patients with varicose veins. La Jolla Vein Care’s Dr. Bunke completed a clinical study at UCSD along with Dr. Maria Alfaro, MD evaluating the correlation between restless leg syndrome and varicose veins.  Eight patients who had restless legs syndrome, and underlying venous insufficiency were studied. These patients underwent treatment of their varicose veins either with foam sclerotherapy or endovenous ablation. All patients had either resolution or improvement of their restless legs symptoms, eliminating the need for neurological medications.  The impact of this study is that all patients with RLS should be screened for venous disease clinically by their doctors. If they have signs of venous disease such as varicose veins, Dr. Bunke recommends an ultrasound evaluation. ‘If RLS symptoms are related to varicose veins, it is correctable by treating the varicose veins, eliminating the need for pharmacologic therapy in many patients and a better night’s sleep,’ says Dr. Bunke.

 

For more information and to book a consultation, please give our office a call at 858-550-0330. 

 

For more information please check out our Youtube Channel at this link. 

 

Restless Leg Syndrome and Venous Insufficiency2022-07-19T17:36:34-07:00

Hemorrhages & Varicose Veins

2022-07-19T17:31:08-07:00

Complications of Untreated Varicose Veins: Bleeding or Hemorrhage Caused by Vein Rupture

 

Untreated varicose veins are at a higher than usual risk of bleeding or spontaneous rupture, hemorrhage. Over time, varicose veins become larger, and the vein wall becomes weak and stretched out. These veins, which are already weak, are also under high pressure (because of venous reflux, or the ‘backflow’ and pooling of blood in these veins). As a result, the high pressure can cause the veins to spontaneously burst and bleed heavily. Because they are under high pressure, they bleed like an arterial bleed and patients describe the bleeding as ‘blood shooting across the room.’  

 

The varicose veins that are susceptible are veins closest to the surface of the skin.

Most patients describe that it occurs during or after a warm shower (warm water causes veins to relax and dilate, allowing more blood to pool within the veins) or during sleep. It is painless and patients report that they notice it because they feel something wet in bed.  Patients who are on blood thinners can lose large amounts of blood, especially if it occurs while they are sleeping. Some people have required blood transfusions. The small blue spider veins around the ankle are equally at risk of rupture as are the larger bulging veins.

hemorrhage

This is a patient who experienced spontaneous hemorrhage of their varicose veins. Notice the appearance of the blue, bulging veins that we describe as, ‘blue blebs.’ These veins are dilated, weak, and are close to the surface of the skin. The pooling blood within these veins causes high pressure, ultimately resulting in a spontaneous rupture or hemorrhage. The bleeding is rapid since varicose veins are under high pressure.  This is a common condition that we see at La Jolla Vein Care.

 

If someone you know has experienced bleeding from their varicose veins, they should be seen by a doctor. Treatment will prevent the veins from bursting again. This is a common condition that we see at La Jolla Vein Care.

 

For more information and to book a consultation, please give our office a call at 858-550-0330. 

 

For more information please check out our Youtube Channel at this link. 

 

Hemorrhages & Varicose Veins2022-07-19T17:31:08-07:00

26, 7, 2022

Do varicose veins cause leg cramps?

2022-12-13T13:23:37-08:00

Leg cramps occurring at night (nocturnal leg cramps) are a common symptom of venous disease. In fact, in the San Diego Population Study, leg cramps were the second most common symptom in people with the venous disease with a prevalence of 14.3%. Leg aching (17.7%) was the most common complaint and tired and swollen legs were also predominant symptoms.

Healthy veins collect the deoxygenated blood from the tissues. The venous blood, which is low in oxygen and high in waste products is returned to the heart and lungs where it is replenished with oxygen and nutrients.  In diseased veins, the blood circulates poorly, allowing blood to pool and become stagnant. The exact mechanism that causes cramping in the legs is uncertain.  But, when the cramping is caused by poorly functioning veins, the symptoms are often alleviated by correcting the underlying problem.  Conservative measures, such as elevating the legs, walking regularly, and wearing compression therapy may reduce the frequency of night cramps. Treating the underlying venous insufficiency may be curative.

There are many causes for leg cramps and if you suffer from night cramps it is important to be properly evaluated to determine the cause.  Cramps that occur with exercise are more likely to be associated with a more serious condition. If your muscles cramp with walking for a short time and recover with rest this may indicate arterial disease.  Other causes for leg cramps include muscle injury, thyroid conditions, pregnancy, electrolyte imbalance, dehydration or other causes.

To help identify the cause, it may be helpful to keep a log of daily activities, or change in activities; for example, heavy exertion may indicate a muscular cause or long periods of standing or sitting may favor the venous disease.  A recent study showed that prolonged standing at work may be an important risk factor for varicose veins and nocturnal leg cramps.

Check with your primary care physician to rule out other causes for leg cramps. Blood tests can check for thyroid, kidney and electrolyte conditions.  You may also have undiagnosed venous reflux.

At La Jolla Vein Care, our vascular imaging scanners help us detect vascular causes of leg pain. For example, we can utilize one of our three duplex ultrasound imaging systems to scan for blood clots in the leg veins (deep venous thrombosis), venous insufficiency and identify significant problems in the arterial circulation.

 

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. 

 

Do varicose veins cause leg cramps?2022-12-13T13:23:37-08:00

27, 6, 2022

Varicocele Treatment

2022-05-23T16:28:37-07:00

Varicocele Treatment

 

In most cases, varicoceles treatment is not necessary. Most men with varicoceles do not experience fertility issues. However, if the condition is causing pain, testicular atrophy, or infertility, you can benefit from varicoceles treatment. The treatment helps in sealing off the affected vein and redirecting the blood flow into normal veins. In case of infertility issues, varicoceles treatment helps in improving the quality of the sperm and sperm count. The procedure that we perform at LA Jolla Vein & Vascular on varicocele is percutaneous embolization of varicocele embolization.

 

The primary goal for varicocele treatment procedures is to help prevent the backflow of blood from the body to the scrotum, helping in cooling off the testes. Surgical procedures will help restrict the blood flow to the veins leading from the testis to the body. However, not all the veins are sealed off. The vassal vein, which is not subject to the same problems as the other varicose veins, is left open to allow blood to leave the testicles after the procedure.

Some of the clear indications that you need varicoceles repair during adolescence include pain, progressive testicular atrophy, and abnormal semen analysis results. While this treatment helps in improving sperm characteristics, it is not clear whether untreated varicoceles can lead to progressive sperm worsening. 

 

The common varicoceles treatment options include (La Jolla Vein & Vascular Only Performs Varicocele Embolization):

 

Percutaneous Embolization (Varicocele Embolization)

Varicocelectomy

Laparoscopic Surgery

Open Surgery

 

Percutaneous embolism is an advanced procedure performed by a radiologist. The specialist usually makes a small cut into a vein in the groin and inserts a tube. The doctor will use X-ray imaging to guide them to the affected veins and insert a coil or a balloon into it through the tube. The procedure helps in blocking the blood flow to the varicocele, shrinking it gradually. This procedure is also done with general anesthesia.

 

Catheter-directed Embolization

 

Catheter-directed embolization is a non-surgical, outpatient treatment performed by an interventional radiologist using imaging to guide catheters or other instruments inside the body. Through mild IV sedation and local anesthesia, patients are relaxed and pain-free during the approximately two-hour procedure.

 

For the procedure, an interventional radiologist makes a tiny nick in the skin at the groin using local anesthesia, through which a thin catheter (much like a piece of spaghetti) is passed into the femoral vein directly to the testicular vein. The physician then injects contrast dye to provide direct visualization of the veins so he/she can map out exactly where the problem is and where to embolize or block the vein. By using coils, balloons, or particles, the interventional radiologist blocks the blood flow in the vein, which reduces pressure on the varicocele. By embolizing the vein, blood flow is redirected to other healthy pathways. Essentially, the incompetent vein is “shut off” internally by preventing blood flow, accomplishing what the urologist does without surgery.

Efficacy of Embolization for Varicoceles

 

Embolization is equally effective in improving male infertility and costs about the same as surgical ligation. Pregnancy rates and recurrence rates are comparable to those following surgical varicocelectomy. In one study, sixty percent conceived were treated for infertility.

In another study, sperm concentration improved in 83 percent of patients undergoing embolization compared to 63 percent of those surgically ligated. Patients who underwent both procedures expressed a strong preference for embolization.

 

Your doctor will make a small 1-inch incision into your scrotum and use a microscope or magnifying glass to see the veins better. The doctor might use local anesthesia to numb the area. General anesthesia can also help you sleep through the procedure.This procedure involves making a much smaller incision and inserting a tube that holds the surgical tools. The surgeon will also use a special camera to see inside you. The procedure is done under general anesthesia to help you sleep through the procedure. The results from the other treatments are similar, only that the incision is small with laparoscopic surgery.The open surgery treatment is usually done on an outpatient basis and using a local or general anesthetic. The surgeon will make a small incision below your groin or abdomen to access the affected vein. Your doctor uses advanced surgical tools such as Doppler ultrasound and a surgical microscope to help guide the procedure. The patient can return to a regular daily routine after two days.

 

Recovery

In most cases, you can go back to your routine after two days of varicose treatment. However, it is advisable to take it easy. Avoid strenuous activities and exercise for about two weeks.

People who have undergone percutaneous embolization tend to recover faster. While you may need a day or two off from work, you can return to your workout program in 7-10 days. If the treatment procedure is to help with fertility, your doctor will perform an additional test in 3-4 months. You will be able to see improved results in 6-12 months. It is important to note that more than 50 percent of men who have undergone the procedure have restored their fertility. Additionally, these surgical procedures are also crucial for teens as they help in slowing testicular growth.

 

Varicocele Treatment2022-05-23T16:28:37-07:00

What is Stenting

2022-05-23T16:16:54-07:00

Stenting

Stenting is a procedure that is performed in combination with Angioplasty and atherectomy.

At La Jolla Vein & vascular, we are dedicated to offering our patients various procedures and treatment options. One of those options is called an Angioplasty. It is also called percutaneous transluminal Angioplasty (PTA), Angioplasty is a medical procedure performed using a catheter. A catheter is usually a thin, flexible tube inserted through an artery and guided by imaging to the narrowed section of the artery. Once the tip of the catheter reaches the narrowed section, the small balloon at the end inflates for a short period. The pressure created by the inflated balloon usually presses the plaque against the artery wall. This procedure will help to widen the arteries, restoring normal blood flow. Stenting is done in combination with an angioplasty. 

 

Years of plaque buildup damages the artery walls. Even after cleaning the artery, the walls are often too weak to stay open. Stenting is a procedure that helps support the blood vessel walls, preventing them from closing after removing the plaque. The procedure involved placing a small mesh tube inside the artery to offer rigid support.

La Jolla Vein & Vascular offers renal artery stenting, which helps support the blood vessels that transport the blood to your kidneys. A patient with a history of arterial disease or who suffers from hypertension has a higher risk of plaque building up in the renal artery wall. Excess plaque on the renal artery tends to weaken the walls. Renal artery stenting offers firm support that ensures the blood flows unobstructed to the kidney.

 For more information and to book a consult, please give our office a call at 858-550-0330.

For more information please check out our Youtube Channel at this link.

 

What is Stenting2022-05-23T16:16:54-07:00

Pros and Cons of Pelvic Vein/Ovarian Embolization Procedure:

2022-05-23T15:56:36-07:00

Pros and Cons of Pelvic Vein/Ovarian Embolization Procedure:

 

Benefits

  • Pelvic Vein Embolization of the ovarian vein or pelvic vein has already been demonstrated to be a safe procedure for relieving pain sensations and improving varicose vein appearance.
  • Embolization helps shut off affected veins, easing pressure from them, so they reduce in size.
  • It’s a minimally invasive technique requiring only a tiny incision in the skin. You won’t even need stitches.
  • Fewer complications than traditional surgery. You also lose less blood, and the incision mark is not even visible. You won’t also need to stay in the hospital for long.
  • 85 % of women who undergo the procedure report feeling much better within 14 days of the operation

Pelvic Vein Embolization Risks

  • You may be allergic to the iodine-based dye and a contrast agent used to take detailed images.
  • A small number of women develop infections after embolization.
  • Since the procedure involves placing a tube inside blood vessels, it may damage them or cause bruising and bleeding at the point of incision.
  • if an embolic agent migrates to the wrong place, it may cut off the oxygen supply to the tissue, i.e., non-target embolism
  • There’s a 10 % chance that the varices may develop in the veins again.
  • It exposes the ovaries to radiation. However, studies have not found any links between the procedure and infertility or abnormal periods.

 

 

How to Prepare for Pelvic Vein Embolization?

 

We offer treatment for Pelvic Vein Embolization at La Jolla Vein & Vascular. The doctor will monitor your blood pressure and heart rate. Some patients suffer slight pain or discomfort following the surgery, which can be managed with simple medications taken by mouth or intravenously through the cannula.

Bed rest is advisable for a short period after the procedure. Most patients are cleared to leave the hospital after 4 hours. However, if you’re in significant pain, you might want to stay for longer and get extra care.

Once discharged, expect to resume your normal activities within a few days; however, don’t drive within the first week following the procedure. Of course, you can wait for longer in case of groin discomfort and get medical care too.

After your operation or therapy, your doctor may urge a follow-up scan and checkup. This is to determine whether the operation was successful and address any changes or adverse effects you may have noticed following the treatment. Just like other varicose veins on the leg, engorged veins in the thigh, vulva, buttocks, etc., may need to be treated separately.

The enlarged veins should gradually reduce in size within a few weeks by preventing reflux in pelvic veins. Even the vulvar varicose veins should disappear. You can also seek treatment for any varices in the lower legs. Various safe treatment options can be used to rid of the condition for good. However, seek treatment for other vein varices only after dealing with pelvic vein varices to reduce the chances of the condition coming back in the future. After pelvic vein embolization treatment, any symptoms you’ve been experiencing due to the veins,  should go away.

  1. You will need to have your warfarin medication altered if you are taking any before the pelvic vein embolization. Consult with a doctor for details.
  2. Keep a list of your medications, even the herbal ones, and inform your doctor of any allergies, including allergic to the iodine dye.
  3. Inform your doctor of any recent medical issues, illnesses, or if you are pregnant. Pelvic venography and vein embolism involve the use of X-rays; you don’t want the fetus exposed to the radiation.
  4. Pack comfortable clothes; you will also be given a gown at the hospital for use during the procedure.
Pros and Cons of Pelvic Vein/Ovarian Embolization Procedure:2022-05-23T15:56:36-07:00

Non Invasive Vascular Laboratory

2022-05-23T15:49:54-07:00

Noninvasive Vascular Laboratory

The Non Invasive Vascular Laboratory at La Jolla Vein & Vascular utilizes advanced, noninvasive, diagnostic, medical ultrasound technology while ensuring high quality results to detect diseases that may affect blood flow in the arteries and veins.  We utilize “state-of-the-art” color duplex ultrasound imagers and indirect testing equipment.

The Vascular Lab offers the convenience of:

  • Non-invasive testing
  • Same-day imaging appointments
  • Follow-up clinic visits with our on-site vascular team
  • Appointments at multiple locations including La Jolla, Poway, Chula Vista, and Solana Beach.

What is Duplex Ultrasound

non invasive

The non invasive Duplex ultrasound involves using high frequency sound waves to look at the speed of blood flow, and structure of the blood vessels. The term “duplex” refers to the fact that two modes of ultrasound are used, Doppler and B-mode. The B-mode transducer obtains an image of the vessel being studied. The Doppler probe within the transducer evaluates the velocity and direction of blood flow in the vessel.

Types of Ultrasound Testing Offered:

Direct testing (duplex imaging)

Venous Non Invasive

  • Deep Vein Thrombosis- upper or lower extremity
  • Venous Reflux

Arterial Non Invasive

  • Abdominal Aorta
  • Abdominal Aortic Aneurysm (AAA) Screening- must meet criteria of SAAAVE Act
  • Carotid Duplex
  • Lower Extremity Duplex

Indirect testing (non-imaging)

Arterial –Segmental pressures and waveforms (P&Ws), upper or lower extremity

 

 For more information and to book a consult, please give our office a call at 858-550-0330.

For more information please check out our Youtube Channel at this link.

Non Invasive Vascular Laboratory2022-05-23T15:49:54-07:00
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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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