10, 10, 2022

La Jolla Vein & Vascular: Duplex Ultrasound

2022-09-19T16:00:31-07:00

The Duplex Ultrasound examination allows us to visualize the blood vessels that are not visible to the naked eye, even blood vessels that are deep within the muscles.  Ultrasound looks at deep and superficial veins in the legs to check for venous-valvular incompetence (the underlying condition that causes varicose veins). The ultrasound examination is used to both identify the veins that have faulty valves and to map the anatomy of the veins, creating a ‘road map.’  This is necessary to make an accurate assessment of the cause and extent of the varicose veins, as well as to formulate the best treatment plan.  This should be done for any individual being evaluated for varicose veins, leg swelling, skin changes, patients who have failed prior treatment, patients who are symptomatic and in some patients with certain anatomic patterns of spider veins.

Before your test:  

This study does not require any preparation. You should not wear your compression stockings the same day as the examination.  Make sure to be hydrated.

 

Who Performs the test?

The ultrasound examination is performed by a Registered Vascular Technologist (RVT). An RVT is a sonographer who completed a two-year ultrasound program, plus additional clinical training and obtained certification by meeting the highest standards by The American Registry for Diagnostic Medical Sonography® (ARDMS®).  It is important that a specially trained RVT perform the study, because over 40 special images are required to meet accreditation standards. All images are reviewed with the physician.

 

How long does the ultrasound study take?

Approximately 45 minutes to an hour.

Is it invasive?

No, the duplex ultrasound a painless and safe study using sound waves to visualize the veins of the leg.

How to prepare?

The duplex ultrasound does not require any preparation. You should not wear your compression stockings the same day as the examination.  Make sure to be hydrated.

“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. 

 

La Jolla Vein & Vascular: Duplex Ultrasound2022-09-19T16:00:31-07:00

How does diabetes relate to vascular health?

2022-09-19T15:50:54-07:00

Diabetes and Vascular Disease

Diabetes Mellitus is a disease that affects the body’s ability to absorb glucose, which is a form of sugar and a major source of energy. There are two types of diabetes, Type 1 (formerly known as juvenile diabetes) and Type 2 (formerly called adult onset diabetes).

Both cause high levels of glucose in the bloodstream. High blood sugar causes many of the long-term effects of diabetes. Too much sugar in the blood damages the linings of the arteries of all sizes, and that can cause atherosclerosis, in which arteries are weakened and/or clogged with plaque.

Atherosclerosis in diabetic patients can lead to:

  • Kidney damage. Kidneys have tiny blood vessels that remove waste from the blood, but diabetes blocks these blood vessels. As the disease progresses, the kidneys lose function and eventually fail.
  • Retinopathy. High blood sugar can cause tiny blood vessels in the eyes to become blocked. When your eye tries to grow new blood vessels, they grow abnormally, eventually leading to blindness.
  • Peripheral artery disease. Glucose damage to the arteries that feed oxygen and nutrients to the legs and feet can lead to pain in the legs, foot sores that won’t heal, chronic pain from poor circulation and in some cases, amputation.
  • Neuropathy. In this condition, the patient loses feeling in the feet and toes. Decreased blood flow caused by clogged arteries can damage the nerves in the extremities.

If you or someone in your family has diabetes, be aware that:

-Patients with diabetes are more likely to get vascular disease.

-Patients with both diabetes and vascular disease are at risk of amputation, blindness, kidney failure and other serious disabilities.

Treatment of diabetes:

Because of the effects, it is very important to aggressively treat both types of diabetes to minimize long-term damage. Careful maintenance of the blood glucose level is the primary goal of this treatment. The HbAl c is a test that estimates the averaged glucose level over a three-month period. Maintaining an HbAl c < 7% is known to lower the risk of amputation, heart attacks, stroke and onset of peripheral arterial disease.

 

Avoiding foods and snacks high in sugar (which can include seemingly innocuous items such as white bread and pasta) can help maintain healthy glucose control. In addition, exercise helps to burn energy and improve your body’s ability to keep your glucose at a healthy level.

Ultimately, medication is often required to maintain this control. For type 2 diabetes, it has been shown that use of an insulin sensitizing medication (usually an oral agent) dramatically decreases cardiovascular complications compared to using only insulin. Consultation with a diabetes specialist can help you to manage your diabetes optimally. There are many new ways to check your glucose at home, including phone apps, and this knowledge and feedback can help you to manage your A1c better.

 

Preventive Care

Preventive care is a critical component of limiting lifetime complications for diabetics. Diabetes predisposes one to heart attacks, strokes, kidney failure and peripheral arterial disease. Knowing the signs and symptoms of these can facilitate you seeking help before a tragic event occurs. However, diabetes can also blunt the usual nerve response to diseases such as the pain of peripheral artery disease. This loss of sensation results in an increased risk of pressure ulcers on the feet. Patients with diabetes should perform routine inspection of their feet to evaluate for any breaks in the skin and notify their doctor immediately if found.Often, nail care can be complicated in diabetic patients. If you have been told you have peripheral neuropathy, ask for a referral to a podiatrist to assist you with nail care to avoid potentially dangerous injuries in nail care. If you do develop any wounds on your feet that do not heal in a reasonable time or seem to be expanding, ask your doctor to refer you to a vascular surgeon here at La Jolla Vein Care.

“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.



How does diabetes relate to vascular health?2022-09-19T15:50:54-07:00

How can smoking affect your vascular health?

2022-09-19T15:46:28-07:00

Smoking and Vascular Disease
The reality of cigarettes is that it is not one product. Every time you smoke, you not only ingest nicotine, but hundreds of other deadly chemicals in the tobacco leaf, paper, contaminants and fertilizers used to grow tobacco. Over time the accumulation of these products causes serious harm to multiple organs. And unlike many things in life, moderation in smoking is not a cure.
Benzene, for example, is a substance on the Environmental Protection Agency’s list of national hazards. It is abundant in tobacco smoke and takes more than 32 hours to completely clear the human body. That means that even ONE cigarette a day continues to keep this poison in your system.
What does smoking do to your arteries?
Smoking is the number one preventable cause of death in the United States. Its effect on heart attacks, peripheral vascular disease and strokes is due to the damage that smoking does to the arteries.
The two chemicals in cigarettes that cause the most trouble are nicotine and carbon monoxide. Nicotine, besides being addictive, has very powerful effects on arteries throughout the body. Nicotine is a stimulant, speeding up the heart by about 20 beats per minute with every cigarette. It raises blood pressure and is a vasoconstrictor, which means it makes arteries all over the body become smaller. That makes it harder for the heart to pump blood through the constricted arteries and it causes the body to release its stores of fat and cholesterol into the blood.
Smoking accelerates the hardening and narrowing process in your arteries; it starts earlier and blood clots are two to four times more likely. Smoking lowers your levels of high-density lipoprotein cholesterol and raises your levels of low-density lipoprotein cholesterol. It decreases the movement of cholesterol through the body, and contributes to its accumulation in your arteries. This puts you at a higher risk for heart attack, stroke, and limb loss.
Your vascular health
Cigarette smoking increases risks of blood clots significantly. If the blood clots in an artery and blood can no longer get through, the tissue that is supposed to be supplied with blood has lost the source of its oxygen and nutrients and dies in minutes. This can result in heart attacks, strokes, and gangrene of the leg.

Smoking effects on the brain:
Smoking increases the risk of stroke by narrowing the arteries in the brain and the carotid arteries in the neck that lead to the brain. In addition, the vessels to the brain can become blocked by a clog or blood clot, which can lead to collapse, stroke and paralysis. If the blood vessels are completely blocked to part of the brain, that part will die. Patients may lose the ability to speak, walk or move normally, or, depending on the part of the brain affected, the stroke may be fatal.

“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.

How can smoking affect your vascular health?2022-09-19T15:46:28-07:00

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

2022-09-19T15:41:12-07:00

Untreated varicose veins are at a higher than usual risk of bleeding or spontaneous rupture.   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.

 

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 & Vascular.

 

“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. 

 

Complications of Untreated Varicose Veins: Bleeding or Hemorrhage Caused by Vein Rupture2022-09-19T15:41:12-07:00

ClosureFast™ an endovenous radiofrequency ablation (RFA) procedure

2022-09-19T15:33:58-07:00

ClosureFast™ an endovenous radiofrequency ablation (RFA) procedure

The procedure, Closurefast is for the backward flow of blood (or “Venous reflux”) in your saphenous vein(s). The great saphenous veins 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 usually return to their usual level of activity the same day.

 

How does the treatment work?

During Closurefast, 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, Closurefast 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 listening to music.  Once you are comfortable, your leg (s) will be prepped with a cleansing solution for the sterile procedure.  The doctor will perform an ultrasound to map the vein (s) 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.

Watch a live radio frequency ablation treatment at La Jolla Vein Care.

“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. 


ClosureFast™ an endovenous radiofrequency ablation (RFA) procedure2022-09-19T15:33:58-07:00

3 Vein Treatments

2022-09-19T15:20:52-07:00

Varicose Vein Treatments

Varicose veins, which are the bulging, twisted veins just beneath the surface of the skin, can be effectively treated after the underlying vein reflux is corrected. There are two main options for removing the varicose veins; either a foamed medication can be injected into the veins causing them to scar and eventually dissolve (foam sclerotherapy), or they can be removed using tiny incisions (phlebectomy).  Sometimes, a combination of both treatment types may be recommended as well as other options listed below. 

 

Venous Reflux Disease Treatments for underlying vein reflux:

 

The ClariVein® procedure

for treatment of backwards flow (or “reflux”) in your 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 the ClariVein® catheter is placed into the unhealthy vein. The catheter closes the vein painlessly by delivering two treatments:

  1. Mechanical treatment with a tiny rotating wire.
  2. Chemical treatment with polidocanol. Polidocanol is a detergent-type sclerosant medication that is commonly used in varicose vein treatment.

This technique is highly effective in closing the vein and only requires one skin puncture, similar to placing an IV.

 

In the video linked here, Dr. Bunke discusses the ClariVein® procedure.  The other video shows how the treatment is done. We offer many other videos on our YouTube channel.   After care instructions can be found on our website under the patient resources tab.

 

ClosureFast an endovenous radiofrequency ablation (RFA) procedure

The procedure is for the backward flow of blood (or “Venous reflux”) in your saphenous vein(s). The great saphenous veins 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 usually 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 IS VARITHENA®?

 

Varithena® is a “microfoam” formulation of polidocanol (sclerosing agent) and CO2. The result is a microfoam that has an appearance and consistency similar to white, foamy shave cream. Ultrasound guidance is used to inject Varithena® microfoam into the vein. The microfoam fills the lumen for circumferential contact where it’s designed to displace blood and destroy the endothelial lining efficiently.

 

“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. 


3 Vein Treatments2022-09-19T15:20:52-07:00

28, 9, 2022

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

Vascular Health & Uterine Fibroids

2022-08-18T16:36:29-07:00

Millions of women around the world are affected by the development of uterine fibroids each year. While it is not a life-threatening condition in itself, the symptoms and potential complications that come with it make it such a pressing medical concern for affected individuals.

 

As only women will usually possess a uterus, it follows that only women are afflicted by this ailment, which is why gynecologists will often be the first ones to make a definite diagnosis. As with so many medical emergencies, knowing the problem early will greatly increase the chances of beating it, which is why the professionals at La Jolla Vein & Vascular are dedicated to administering reliable, accurate, and entirely effective diagnostics, therapies, and treatments to all clients coming through our doors.

 

Let’s take a closer look at what exactly we will be dealing with should uterine fibroids turn out to be the issue at hand.

 

What are uterine fibroids? 

 

To understand what uterine fibroids are, the first thing one should do is separate the two terms making up the condition. A fibroid is a term to refer to a type of tumor that has ‘muscular’ characteristics. They are also referred to as a leiomyoma and can appear singularly or in formations or in lumps. 

 

They are known as uterine fibroids since they will appear in the patient’s uterus. Although they are not cancerous in almost all instances, they will range in size from patient to patient, from as small as an apple seed to as large as a grapefruit and beyond, in some unusual instances. 

 

It is important for all women to be aware of the dangers presented by uterine fibroids, not only owing to the potential harm that the condition might bring about but due to the high rate of prevalence among the female population affected in some way. By the time they are 50 years old, it is estimated between 20 to 80 percent of women will have developed uterine fibroids, with most cases affecting the 40’s to early 50’s. 

 

Symptoms to look out for: 

 

Fibroids go undiscovered in most patients due to the lack of symptoms accompanying them, but some patients will experience some symptoms, including:

 

  • Frequent urination due to pressure being exerted on the patient’s bladder
  • Lower back pain
  • Pain during sexual intercourse
  • Enlargement of the lower abdomen, with severe and extremely rare instances causing the appearance of apparent pregnancy in the patient where none exists
  • Heavy bleeding and/or painful bleeding during periods sometimes resulting in a medically significant depletion of blood in the patient (anemia)
  • Greatly increased risks of complication during pregnancy and delivery, with uterine fibroid patients requiring cesarean sections at six times the average rate.
  • Reproductive health problems such as infertility are very rare outcomes.

 

“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. 

Vascular Health & Uterine Fibroids2022-08-18T16:36:29-07:00

La Jolla Vein & Vascular: Diagnosis of Peripheral Arterial Disease

2022-08-18T15:52:03-07:00

Peripheral Arterial Disease – Diagnosis

At La Jolla Vein & Vascular, we have highly trained physicians who offer a comprehensive diagnosis to develop customized treatments of Peripheral arterial disease (PAD). We understand that no two patients’ conditions are similar. Our full-service vascular lab provides state-of-the-art testing to ensure that our physicians address each patient case quickly and accurately. Our doctors and nurses also have broad experience in this field and use advanced tools to achieve limb-saving results even for challenging, impaired patients. Our PAD diagnosis procedure involves the following:

Detailed Physical Exam

To help diagnose PAD, our skilled 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.

Detailed Physical Exam

Ankle-brachial index (ABI)

Ankle-brachial index (ABI test) helps diagnose 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.

Arterial Ultrasound

La Jolla Vein & Vascular doctors also use ultrasound-guided procedures to determine whether a specific vein or artery is blocked or open. The procedure is non-invasive, meaning that you will not experience any pain. The technique visualizes the artery with sound waves that measure the blood volume that flows in the veins and arteries. After the procedure, the patients receive a thorough consultation. The doctor will recommend the most effective treatment option to help promote blood flow to the feet and leg.

The treatment will help reduce leg pain, promote healing of sores and increase the mobility of the affected limb. Doctors utilize two main ultrasound methods. The first method is the Doppler ultrasound utilized to locate areas with blockages or reduced blood flow. The procedure involves using a handheld device that sends sound waves through the arteries to measure how fast blood flows. The second method is the segmental Doppler pressure testing that checks various parts of the legs for blocked or narrowed arteries. The procedure is similar to the ABI test, but the ultrasound device will amplify the sound of blood flow, making it easy to measure blood pressure.

Angiography (venography)

Angiography is minimal invasive testing that helps to visualize and diagnose blockages inside veins and arteries. In this procedure, the physician will insert a thin tube that injects a special dye that enables blood vessels to appear on an X-ray. As the dye is introduced to the arteries and veins, fluoroscopy imaging captures the detailed images to see the extent of blockages in the arteries.

Blood Tests

Doctors also take a sample of your blood to measure the levels of cholesterol and triglycerides. Blood samples are also used to check for diabetes.

Magnetic Resonance Angiography (MRA)

MRA tests are conducted to examine the structure of the arteries in your leg. However, the doctor will speak to you before using the procedure. Magnetic resonance angiography is not recommended for people with metal implants in their bodies.

 

“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.

La Jolla Vein & Vascular: Diagnosis of Peripheral Arterial Disease2022-08-18T15:52:03-07:00

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
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