4, 1, 2023

Meet our team of vein & vascular specialists: Dr Lucas

2022-12-26T10:58:13-08:00

Our vein and vascular specialists are not your average doctors.  They train and teach other doctors, medical students, physician assistants, and empower and educate patients everyday with knowledge and choices.  They lead clinical research studies and contribute to scientific journal and textbook publications.  Our recent research made the cover of the “Journal for Vascular Ultrasound” in March, 2018.  Our doctors continuously strive to elevate the standard in vein care- they are fellowship-trained, board certified in venous and lymphatic disease, and earned additional credentials in ultrasound interpretation to provide comprehensive vein care for all patients.

 

Sarah Lucas MD, FACS, RPVI

 Vascular Surgeon

vascular

Dr. Sarah Lucas, MD, FACS, RPVI is a board-certified vascular surgeon who has chosen to focus her practice on the care of patients with venous and lymphatic disease. She is also a diplomate of the American Board of Venous and Lymphatic Medicine. She is a graduate of the Duke School of Medicine and the integrated vascular surgery residency of Georgetown University Hospital and Medstar Washington Hospital Center in Washington, DC. She returned to Duke as a faculty member following graduation.She and her husband then relocated to Memphis, Tennessee for his pediatric surgery fellowship. During that time, she was on staff at the Memphis VA Medical Center, where she served as faculty for the vascular surgery fellowship of the University of Tennessee Health Sciences Center.

Dr. Lucas and her husband are delighted to have found their permanent home in San Diego, where he is a pediatric surgeon at the Naval Medical Center.

Dr. Lucas has authored numerous peer-reviewed publications and a book chapter in the field of vascular surgery. She is active in the Society for Vascular Surgery and a member of the Young Surgeons’ Committee. Dr. Lucas joined La Jolla Vein Care in 2018. In addition to her role at La Jolla Vein Care, she also manages patients with vascular wounds at the Scripps XIMED wound care clinic.

Dr. Lucas is a Fellow of the American College of Surgeons. Surgeons who become Fellows of the College have passed a comprehensive evaluation of their surgical training and skills; they also have demonstrated their commitment to high standards of ethical conduct.

 

Peer-Reviewed Journals:Dr. Sarah Lucas

 

“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. 

 

Meet our team of vein & vascular specialists: Dr Lucas2022-12-26T10:58:13-08:00

Meet our team of vein & vascular specialists: Dr Bunke

2022-12-26T10:53:06-08:00

Our vein specialists are not your average doctors.  They train and teach other doctors, medical students, physician assistants, and empower and educate patients everyday with knowledge and choices.  They lead clinical research studies and contribute to scientific journal and textbook publications.  Our recent research made the cover of the “Journal for Vascular Ultrasound” in March, 2018.  Our doctors continuously strive to elevate the standard in vein care- they are fellowship-trained, board certified in venous and lymphatic disease, and earned additional credentials in ultrasound interpretation to provide comprehensive vein care for all patients.

 

Nisha Bunke, MD FACPh, RPhS

Venous Disease Interventionist, Vein Clinic Medical Director

vein

Dr. Nisha Bunke was the first physician in the United States to complete fellowship training supported by the American Vein and Lymphatic Society (formerly known as the American College of Phlebology) in 2008 and is a diplomate of the American Board of Venous and Lymphatic Medicine. Over the past decade, Dr. Bunke has dedicated her career to treating patients with venous and lymphatic conditions and advancing the field of vein care.

Being inspired by her mentor, world-renowned vascular surgeon, Dr. John Bergan, who emphasized that venous disease is a special condition that requires specialized care, she founded La Jolla Vein Care in 2010. Under her leadership, La Jolla Vein Care was awarded accreditation in Vein Clinic and Vascular Testing by the Intersocietal Accreditation Commission (IAC). La Jolla Vein Care is the first dedicated vein care facility in the region to earn this distinction.

Prior to turning her complete attention to La Jolla Vein Care, she has held appointments as a Volunteer Clinical Instructor of Surgery at the University of California San Diego (UCSD) School of Medicine, and Veterans (VA) Medical Center.  In addition to these duties, for five years, Dr. Bunke managed the vein clinics at the VA Medical Center La Jolla, providing vein care for our veterans.  She was also a physician at UCSD Healthcare System’s Department of Vascular Surgery, where she evaluated and treated patients with venous disease.

Dr. Bunke is a physician and scientist, actively leading clinical research studies.  In 2009, Dr. Bunke was awarded the International Union of Phlebologie Research Fellowship and the Best Young Presenter Award in Monaco.  Collectively, Dr. Bunke and Dr. Bergan were awarded the 2008 JOBST Research Award for the Advancement of Phlebology for their research on Inflammatory Biomarkers of Venous Insufficiency. Dr. Bunke also developed Recova, a post-surgery recovery cream.

Dr. Bunke has been named as a finalist by the San Diego Business Journal’s Women Who Mean Business Award and San Diego Magazine’s Woman of the Year award.  In 2018, she was named as the top 25  Women of the Year by the San Diego Business Journal.

Dr. Bunke’s Affiliations

Moreover, Dr. Bunke is a member of the Scripps Ximed Medical Group, The Clinical and Translational Research Institute (CTRI) of the University of California San Diego (UCSD), the American Medical Association (AMA), San Diego County Medical Society, Society for Vascular Medicine, American Vein and Lymphatic Society, American Venous Forum (AVF) and the Society for Vascular Ultrasound (SVU). Dr. Bunke has numerous publications in both scientific journals and medical textbooks.

Dr. Bunke is co-editor of the most widely used textbook for vascular physicians, “The Vein Book”

vein

Books/ Book Chapters: Dr. Nisha Bunke

Bergan, JJ, Bunke, N. “Outcome Measures in Venous Disease.” In:  Fast Facts- Vascular and Endovascular Surgery Highlights 2008-09.  Davies, A., Mitchell, A. M. Health Press UK

Bergan, JJ. Bunke, N.  “Varicose Veins and Chronic Venous Insufficiency.” In: Total Endovascular Series Venous Diseases Contemporary Management.’ Lumsden, A, Davies, M.

Bergan, JJ, Bunke, N.  “Venous Disorders.”  In:  Educational Review Manual in General Surgery. 8th Edition. Castle Connolly Graduate Medical Publishing.

Bergan, JJ, Bunke, N. “Pathophysiology of Chronic Venous Disease.”  In:  The European Venous Course Book.

Bergan JJ, Bunke, N. “Endovenous Procedures in Venous Disease.”  In:  Peripheral Endovascular Interventions.  White, R, Fogarty, T.  3rd Ed.

Bergan, JJ, Pascarella, L, Bunke, N. “Venous Anatomy, Physiology and Pathophysiology.”  In: Treatment of Leg Veins, 2nd ed.  Alam, M., Silapunt, S. Martin Mellor Publishing Ltd. UK

Bergan, J. Lee, BB, Bunke N.  “Lymphatic Disease.”  In: Clinical Review of Vascular Surgery. Edited by Sapan Desai, MD, PhD and Cynthia Shortell, MD.

Bergan, J. and Bunke, N. General Considerations. In: Lymphedema: A Concise Compendium of Theory and Practice. Edited by Byung-Boong Lee, John Bergan, Stanley G. Rockson 2011.

Bergan, JJ, Bunke-Paquette, N, editors. The Vein Book, 2nd edition. Oxford University Press, New York, NY USA. 2014

Bunke-Paquette, N. “Complications of Liquid Sclerotherapy.” In: The Vein Book, 2nd ed. Bergan, JJ, Bunke-Paquette, N. Oxford University Press, New York, NY USA. 2014

Loerzel, N, Ratcliff V, Bunke-Paquette, N, et al. “Ultrasound Examination of the Patient with Primary Venous Insufficiency.” In: The Vein Book, 2nd ed. Bergan, JJ, Bunke-Paquette, N. Oxford University Press, New York, NY USA. 2014

Bunke-Paquette, N, Loerzel, N, Bergan, JJ. “Ultrasound-Guided Catheter and Foam Therapy for Venous Insufficiency.’ In: The Vein Book, 2nd ed. Bergan, JJ, Bunke- Paquette, N. Oxford University Press, New York, NY USA. 2014

Bergan, JJ, Pascarella, L, Bunke-Paquette, N. “Perforating Veins.” In: The Vein Book, 2nd ed. Bergan, JJ, Bunke-Paquette, N. Oxford University Press, New York, NY USA. 2014

Bunke-Paquette, N. Russell, T, Broder, K, Li, A. “Medical Management of the Venous Leg Ulcer.” In: The Vein Book, 2nd ed. Bergan, JJ, Bunke-Paquette, N. Oxford University Press, New York, NY USA. 2014

Peer-Reviewed Journals

Bunke N, Brown K, Bergan J. Foam sclerotherapy: techniques and uses. Perspect Vasc Surg Endovasc Ther. 2009 Jun;21(2):91-3

Bunke N, Brown K, Bergan J. Phlebolymphemeda: usually unrecognized, often poorly treated. Perspect Vasc Surg Endovasc Ther. 2009 Jun;21(2):65

B.B. Lee, M. Andrade, P.L. Antignani,F. Boccardo, N. Bunke, et. al. Guidelines: Diagnosis and treatment of primary lymphedema consensus document of the international union of phlebology (IUP)-2013. International Angiology. 2013 Dec: (32): 541-574

“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. 


Meet our team of vein & vascular specialists: Dr Bunke2022-12-26T10:53:06-08:00

28, 12, 2022

What is PAD (Peripheral Arterial Disease)?

2022-10-24T15:03:43-07:00

What is Peripheral Arterial Disease?

Peripheral Arterial Disease is a disease we see and treat at La Jolla Vein and Vascular. You probably are familiar with the terms angina and heart attack, which are related to a blockage of blood flow to the heart. That same sort of blockage can occur elsewhere in the body, depriving the limbs (the peripheral parts of the body) of oxygen and nutrients. Left untreated, the disease can lead to amputation.

Healthy peripheral arteries are smooth and unobstructed, allowing blood to freely provide the legs with oxygen, glucose and other nutrients. As we age, peripheral arteries build up plaque, a sticky substance made up mostly of fat and cholesterol. Plaque narrows the passageway within the arteries and causes them to become stiff, which then leads into peripheral arterial disease. 

A moderate blockage in one of arteries in a major leg muscle, such as the calf or thigh, can cause pain when walking.This pain can be temporarily decreased with rest, but will act up again with more walking or activity.

Lower extremity pain, similar to angina, is called claudication by medical providers. The pain itself is not limb-threatening but it is a sign that the person should make lifestyle changes and see a doctor. 

Examples of possible treatments for peripheral arterial disease include: 

  • Smoking cessation 
  • Daily exercise
  • Medical management

If the disease becomes more severe, the limb can be starved of basic nutrients and the patient begins to suffer pain at rest (especially at night). Sores that won’t heal may develop on the feet. This is a very concerning sign for losing toes or even amputation of the leg. An urgent referral to a vascular surgeon is necessary to prevent limb loss in this situation.

Causes and risk factors of Peripheral Arterial Disease:

  • Age
  • Gender—males are more prone to the condition than females
  • Hypertension (high blood pressure) 
  • Diabetes
  • Smoking
  • High cholesterol
  • Obesity
  • Lack of exercise
  • Family history of vascular problems

Leg pain does not always indicate PAD, but older patients, especially those who are at risk, should see a physician. A simple, noninvasive ultrasound and leg blood pressure examination can diagnose peripheral arterial disease and determine its severity.

If you experience symptoms of peripheral arterial disease, ask your primary care physician to refer you to a vascular surgeon. Vascular surgeons can perform any necessary treatments, including medication management, minimally invasive endovascular angioplasty and stent procedures, and open bypass surgery.

Treatment for Peripheral Arterial Disease:

Depending on the severity of your condition, treatment options may include lifestyle changes, medications, minimally invasive angioplasty/stenting, or open bypass surgery.

 

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

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

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

What is PAD (Peripheral Arterial Disease)?2022-10-24T15:03:43-07:00

Vascular Health and Physical Activity

2022-10-24T12:56:53-07:00

Physical activity helps to burn calories, increase the heart rate, and keep blood flowing at a healthy rate for your vascular health. All of these contribute to vascular health. 

If your doctor has diagnosed you with vascular disease, or if you have concerns about your vascular health, starting some good habits can help keep vascular complications at bay. Daily exercise has been found to have a significant positive effect on vascular health, along with other good lifestyle choices, such as not smoking, eating heart-friendly foods and maintaining a healthy body weight.

Your Vascular Health

Exercise can impact several artery diseases. A regular exercise routine may reduce the risk of stroke, the fourth leading cause of death in America according to the CDC’s 2010 National Vital Statistics Report. In 2010, 137,000 Americans died of stroke. Studies show that patients with peripheral arterial disease (PAD) may be successfully treated with exercise therapy and possibly avoid interventions. Regular exercise also decreases the growth rate of abdominal aortic aneurysms (AAA), research has found.

The United States Centers for Disease Control and Prevention (CDC) recommends 150 minutes of physical activity per week for adults ages 18 to 64. The activity can be a combination of moderate intensity aerobics and strength training, and should continue for at least 10 minutes at a time.

Moderate-intensity aerobic activities that increase the heart rate and cause sweating which are great for vascular health:

  • Riding a bicycle at a casual pace 
  • Playing doubles tennis
  • Actively playing with children
  • Mowing the lawn
  • Gardening, raking, or bagging leaves
  • Light snow shoveling
  • Water aerobics
  • Ballroom dancing

Vigorous activity that increase the heart rate that are great for vascular health:

  • Hiking uphill or with a heavy backpack,  race walking, jogging, running
  • Riding a bicycle fast or riding hills, more than 10 miles/hr
  • Rollerblading / inline skating at a brisk pace 
  • Playing basketball, football, soccer, etc.
  • Cross-country skiing
  • Jumping rope
  • Aerobic dancing
  • Heavy gardening continuous digging and hoeing
  • Swimming laps
  • Playing singles tennis

Twice weekly strengthening activities include:

  • Sit-ups, push-ups
  • Weight lifting
  • Heavy gardening such as digging and shoveling 
  • Yoga

The lack of regular physical activity results in 250,000 deaths annually, according to a 2003 report in the medical journal, Circulation. People who are the least physically fit have a mortality risk 4.5 times higher than physically fit people.

To add physical activity into your daily schedule:

  • Select enjoyable activities 
  • Work out with a friend
  • Encourage family members to participate
  • Measure progress through a daily exercise journal

Physical activity is not just good for your veins and arteries, just about every part of your body can benefit. According to the CDC, exercise also helps your vascular health and in addition helps:

  • Maintain healthy weight
  • Reduce the risk of cardiovascular disease; can lower blood pressure and improve cholesterol levels
  • Reduce the risk for type 2 diabetes; can help control glucose levels
  • Reduce the risk of colon and breast cancer
  • Strengthen bones and muscles – can increase or build muscle mass and strength; can slow the loss of bone density that comes with age; can help with arthritis and other joint conditions
  • Keep thinking, learning, and judgment skills sharp 
  • Reduce the symptoms of depression and anxiety
  • Improve the ability to complete daily activities and prevent falls for older adults
  • Increase the chances of living longer by reducing the risk of dying from heart disease and some cancers

 

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

 

Our accredited center is also a nationally known teaching site and center of excellence. 

 

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

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

 

Vascular Health and Physical Activity2022-10-24T12:56:53-07:00

What is Uterine Fibroid Embolization (UFE)?

2022-10-24T15:28:45-07:00

What is Uterine Fibroid Embolization (UFE)?

With modern medication and care, conditions like fibroid tumors have become more treatable and easier to manage. Uterine Fibroid Embolization (UFE), for instance, is a fairly straightforward procedure used in the treatment of fibroid tumors in the uterus.

Sometimes referred to as uterine artery embolization (UAE), the uterine fibroid embolization (UFE) procedure helps countless women plagued by fibroid tumors.

What does the uterine fibroid embolization treatment entail, and how can you prepare for the procedure? Here’s everything you need to know about uterine fibroids treatment.

What is Uterine Fibroid Embolization?

The muscular walls of the uterus can sometimes be invaded by non-cancerous fibroid tumors. These tumors are also known as myomas and are a form of benign tumors. While these fibroid tumors rarely become cancerous, they can lead to other severe conditions such as increased menstrual bleeding, bowel or bladder pressure, and pelvic discomfort. 

Admittedly, while uterine fibroid embolization shows a high success rate, more research is still needed on the subject. For instance, at the moment, the procedure is usually performed on women who no longer desire to get pregnant. The UFE procedure may also be used on women who wish to avoid a hysterectomy procedure. 

When is Uterine Fibroid Embolization Used? 

 

As mentioned above, uterine fibroid treatment is rather straightforward and minimally invasive. As a result, the procedure can be used in a wide variety of cases. Some of the instances where the treatment is necessary or advocated for include;

  • Malignant gynecological tumors
  • Hemorrhage after childbirth
  • General or specific trauma

 

How to Prepare for a Uterine Fibroid Embolization Procedure

 

The healthcare professional will first need to ascertain if the fibroid tumors are the underlying cause of any visible and diagnosable symptoms. Afterward, they’ll need to determine the size, location, and the number of fibroids. This can be done with the help of an ultrasound machine or magnetic resonance imaging (MRI) equipment.

Moreover, your gynecologist may also need to run a physical examination through a laparoscopy examination. This test gives a clearer picture of the uterus and the invasive fibroids. You could also have a biopsy of the inner lining of the uterus if you are bleeding excessively in between your periods. The procedure known as endometrium helps rule out cancer as the cause of bleeding.

If you are on any medication, supplements, or herbal remedies, you’ll need to inform the doctor before the procedure. Additionally, make a list of any known allergies, including general and local anesthesia and the dye or contrast materials.

It’s also wise to notify the healthcare team if you have recently suffered an illness, just finished treatment, or are on other medication. For example, if you’re on blood thinners, the healthcare provider may advise you temporarily halt the medication in preparation for the procedure.

Women who suspect they are pregnant should let the doctor know well before the uterine fibroid embolization treatment. Some imaging tests are usually not performed during pregnancy in a bid to minimize any radiation exposure to the fetus. In the case of an imaging test, such as an x-ray, which is essential to the operation, particular care guidelines must be followed to manage and reduce radiation exposure.

While preparing for the procedure, you’ll likely be put off solid meals after midnight to the procedure’s day. While the procedure takes a few hours, the doctor could request to stay overnight for further observation.

 

What Equipment to Expect

 

Since this is a minimally invasive procedure, the tools and equipment used are reasonably common and risk-free. Some of the equipment to be used in uterine fibroid embolization treatment includes a catheter, x-ray machines, and various embolic agents and medications.

The synthetic material used is known as embolic agents and varies in composition and efficacy. The three most common types of embolic agents are;

-Gelfoam whose texture resembles spongy material

-Polyvinyl alcohol, which resembles coarse sand

-Microspheres, which is a polyacrylamide sphere coated with gelatin

These tolls, equipment, and medication are all safe to use during the uterine fibroid embolization treatment.

 

Benefits and Risks Associated with Uterine Embolization Treatment

 

Some of the advantages of uterine fibroid embolization include;

-There’s no need for surgery as the procedure is minimally invasive

-You can resume regular activity sooner and faster

-The procedure is highly effective, boasting well over 90% efficacy rating

-Fibroids rarely regrow after the uterine embolization treatment

-On the other hand, some of the risks that could occur during the procedure are;

-The procedure pierces the skin and could leave an infection if not properly cleaned

-The embolic agents need to be guided carefully, or they could lodge in the wrong area

-Fibroids can lead to chronic pain and an array of other conditions. With uterine embolization treatment, you can now get relief and get back to your healthy self.

 

What To Expect during Uterine Fibroid Embolization Procedure

 

A UFE usually takes between 1 and 3 hours and patients usually require about 6 hours of bed rest after the procedure. Patients may experience mild discomfort as the embolization takes full effect. The fibroid tumors breaking down and exiting the body may cause light bleeding for the few weeks after the procedure. Most patients can expect to return to normal activity 7 to 10 days after the procedure. Our physicians will most likely recommend a follow-up consultation after the UFE 1 to 3 weeks afterward and an ultrasound or MRI 3 to 6 months later to monitor your progress.



La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

 

Our accredited center is also a nationally known teaching site and center of excellence. 

 

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

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 


What is Uterine Fibroid Embolization (UFE)?2022-10-24T15:28:45-07:00

30, 9, 2022

What you need to know about Varicoceles

2022-08-18T17:08:55-07:00

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. Varicoceles 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 Varicoceles Affect the Testis?

While numerous theories exist, medical experts agree that varicoceles 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.

“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 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 Varicoceles2022-08-18T17:08:55-07:00

Risk Factors of Developing Uterine Fibroids

2022-08-18T16:57:50-07:00

Who is at Risk of Developing Uterine Fibroids?

There are certain natural circumstances, habits, and lifestyle choices that have been shown to come with an increased chance of developing uterine fibroids, as follow:

–Ethnic Origin

Research indicates that women of African American ethnicity are at a significantly higher risk of developing uterine fibroids than Caucasian women for comparison. 

–Age

A woman’s advancing age places her at increased risk of developing uterine fibroids. The condition will mostly be found in women in their mid-late forties or early fifties, where the majority enter or pass through their menopausal years. 

–Family History

Simple stated, this means that those with a history of uterine fibroids will be more likely to develop the condition. 

–Eating Habits

It is believed that the consumption of red meat (beef, ham, etc) in copious amounts will increase the risks of uterine fibroid development. The consumption of green vegetables, on the other hand, is thought to reduce these odds. 

–Obesity

Being overweight is considered to be another variable increasing women’s risk of developing this condition, with overweight patients being two to three times more likely to be affected than the average population. 

Treatment Options for Uterine Fibroids

The varied nature of uterine fibroid cases and how they affect different patients in different ways means that dealing with the condition has numerous different approaches. Consultations between patients, whether presenting with symptoms or not, and their physicians should be able to see them agree on a course of action that will satisfy the patient’s best interests. Aside from medication, the typical treatment for fibroids is traditional surgical procedures. At Pedes Orange County, we offer a minimally invasive treatment option that can be reviewed below:

Traditional Surgical Procedures

These are considered invasive surgeries that involve extensive physical intervention. They include:

  • An abdominal myomectomy is an option mostly employed in cases where very large, very deeply embedded, or multiple fibroids are encountered. An open abdominal procedure is often the second-to-last option for patients who see hysterectomies as a last resort.
  • Hysterectomy: This major surgical intervention involves the entire removal of the patient’s uterus and is the only guarantee against the recurrent development of uterine fibroids afterward. While most women will have the option of retaining their ovaries, some will have to undergo hormone replacement therapy if they are not to enter menopause.

Minimally Invasive Surgical Procedure (Uterine Fibroids Embolization by La Jolla Vein & Vascular)

At La Jolla Vein & Vascular, we specialize in Uterine Fibroids Embolization. This minimally invasive surgical procedure involves destroying fibroid masses without necessarily removing them entirely. The techniques are most commonly applied in clinical settings due to their effectiveness, proven track record, and minimal patient impact.

  • Uterine artery embolization: (Also known as Uterine fibroid embolization). Embolic agents (small particles) will be introduced into arteries to block blood flow through them, thus starving fibroids of the nutrients needed for their survival and growth.

In surgical procedures that do not entirely remove the uterus, there will be a remaining risk of new uterine fibroid development in the future.

Why Uterine Artery Embolization (UFE) Instead of a Hysterectomy

Benefits of UFE Over Hysterectomy

Uterine artery embolization (UFE ) is a minimally invasive procedure that effectively treats uterine fibroids and is considered an alternative to uterine fibroid surgery removal. Uterine artery embolization (UFE) is typically performed as an outpatient procedure, which means that most women go home the same day for recovery.

UFE has several benefits over hysterectomy. Besides involving only a small nick in the groin or wrist for catheter insertion, the uterus is preserved. There is no scar with UFE. For a UFE, conscious sedation is used, unlike a hysterectomy, where the woman receives general anesthesia. The recovery time for UFE is generally within 2 weeks, which is significantly faster than the usual 6-week recovery time after hysterectomy.

Women who have a hysterectomy that removed both the uterus and ovaries usually get estrogen replacement therapy (ERT) alone. But women who have only the ovaries removed need both estrogen and progestin because estrogen alone can increase the risk of cancer in the uterus.

The recovery time for UFE is generally within 2 weeks, which is significantly faster than the usual 6-week recovery time after hysterectomy.

The idea of having your entire uterus removed is psychologically daunting for women as some women may still want the option to carry a child, do not want to undergo a general surgery, and/or feel like removing the uterus takes away part of their identity as a female.

Treatment for Uterine Fibroids

With modern medication and care, conditions like fibroid tumors have become more treatable and easier to manage. Uterine fibroid embolization, for instance, is a fairly straightforward procedure used in…

“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 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. 

Risk Factors of Developing Uterine Fibroids2022-08-18T16:57:50-07:00

The cause of Uterine Fibroids

2022-08-18T16:47:51-07:00

What Causes Uterine Fibroids?

While the science is not completely settled on what exactly causes or is behind the formation of uterine fibroids in human beings, there are certain factors that researchers believe play significant roles in triggering their growth or development.

Genetics

In 50 percent of cases, patients will be found to have some genetic abnormality. In many instances, some erroneous translocation will be discovered on some chromosomes.

Hormones

While we may not be completely certain as to what lies at the root cause of uterine fibroids, it has been clearly demonstrated that hormones play a large role in determining their growth or progression. While a woman is pregnant, they will see rapid growth due to the presence of the hormones estrogen and progesterone. Should the patient use anti-hormone medication, the opposite will happen – the fibroids will shrink. Furthermore, fibroids will stop growing or begin shrinking once a patient reaches menopause, which is the point at which these hormones also cease being produced in the female body.

Testing and Diagnosis of Uterine Fibroids

In many cases, especially those whereby uterine fibroids do not present any noticeable symptoms for the patient, this condition will be discovered in a regular pelvic exam. This is a routine checkup carried out by gynecologists. While this checkup might determine the presence of a mass or lump on the uterus, further testing will have to be carried out to make a definite diagnosis.

These testing methods include:e09eQd4jBPpzFnkwnMj7SJxpMh25WCLWoP3loxbQ6e8AX7s1hnnTfHS56W7p 4P7RhhoJW2ZYHIvZJeIsOhXGMM9C CMIYZ3Fs7WPPuSENG3E

Note: Upon learning that fibroids are a type of tumor, the foremost concern for many patients is whether the tumor is cancerous or might predispose them in some way to developing cancer. Fibroids are rarely cancerous, with the chances of such fibroids (leiomyosarcomas) arising at less than one in a thousand.  Additionally, the presence of fibroids in no way increases a patient’s chances of developing any type of cancer.

“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 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. 

The cause of Uterine Fibroids2022-08-18T16:47:51-07:00

Is there a treatment for Non-Healing Wounds & Ulcers?

2022-08-18T15:54:05-07:00

Treatment of Non-Healing Wounds & Ulcers

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

Compression Wrapping

Specialized Dressings and Topical Medication

Patient Self-Care and Education

Negative Pressure Therapy (NPWT)

Surgery

Growth Factor Therapy

Debridement (removal of dead tissue)

Compression Wrapping

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

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

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

Specialized Dressings and Topical Medication

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

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

Patient Self-Care and Education

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

Negative Pressure Therapy (NPWT)

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

Surgery

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

Growth Factor Therapy

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

Skin Graft Therapy

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

Debridement (removal of dead tissue)

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

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

La Jolla Vein & Vascular Treatments for Non-Healing Ulcers

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

 “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 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. 

Is there a treatment for Non-Healing Wounds & Ulcers?2022-08-18T15:54:05-07:00

What you need to know about: Non-Healing Ulcers & Wounds

2022-08-18T15:55:24-07:00

Non-Healing Ulcers &  Wounds

We might all be familiar with ulcers in a general manner, but certain types of ulcers behave quite differently due to various contributing factors. These are non healing ulcers or non healing wounds, and if not treated with care and in good time, such wounds can pose a serious risk to the patient’s health. Severe cases may lead to amputation of the affected limbs or loss of life in the most extreme circumstances. The nonhealing ulcers cases we treat here at La Jolla Vein & Vascular fall under peripheral arterial disease (PAD) and a subcategory of arterial disease.

Non-healing wounds or ulcers do not follow the usual healing process and are referred to as chronic wounds should they persist beyond 3 weeks. Such wounds can be a heavy burden to live with for anyone. Still, the board-certified vascular surgeons and specialists at La Jolla Vein & Vascular are dedicated to administering effective treatment and management solutions to all patients so they may resume a healthy, productive, and pain-free life.

Types of Non-Healing Ulcers

In general, patients will present with one of three categories of non-healing ulcers, with these categories being broadly defined by the major causative factors allowing for their development. These are:

Arterial or Venous Ulcers

These are found to account for between 70% up to 90% of non-healing wounds or non-healing ulcers. Mostly occurring in elderly patients, they are believed to come about as a result of a failure of the valves in a person’s blood vessels of both arteries and veins. These valves are responsible for preventing the backflow of blood as it passes within them. The consequent outcome is a lack of nutrient and oxygen-rich blood from reaching the affected tissues and sets up the conditions favoring non-healing wounds.

Pressure Ulcers

These are ulcers that are brought about by the restriction of blood flow to certain regions of the body due to the persistent and prolonged application of pressure upon them. It is mostly encountered among patients with full or partial paralysis and those who are bedridden for extended periods.

Diabetic Ulcers

These are also highly prevalent chronic wounds, and are on the increase among patients owing to the ever-increasing cases of diabetes among the population. In fact, the prevalence of chronic wounds among diabetics makes this demographic 15% more likely to have to undergo limb amputation as a complication of the condition.

The high amputation rate among diabetics is attributable, in part, to the neuropathic effects of the ailment. Neuropathy leads to a lack of pain perception in the affected individual, meaning that they may be entirely unaware of minor wounds on their feet and legs in good time, allowing for their infection or repeat injury. It is also made more likely by the immunosuppressive effects of the condition, which makes the patient more vulnerable to infection.

“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 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: Non-Healing Ulcers & Wounds2022-08-18T15:55:24-07:00
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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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