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20, 5, 2022

Signs and Symptoms of Varicoceles

2022-04-29T16:45:32-07:00

 

 

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.

Signs and Symptoms of Varicoceles

Most often, Varicoceles have no symptoms or signs. As mentioned earlier, you will barely notice it. However, although rarely, the condition might cause pain. When it does cause pain, it might;

  • Switch from a sharp to a dull discomfort
  • Become worse over the day
  • Increase when due to physical exertion or standing for extended periods
  • Pain that goes away when you lie on your back
  • Impaired infertility

Over time, varicoceles may become more enlarged and become noticeable. Varicoceles are often described as looking like a “bag of worms” sometimes, the condition may also cause a swollen testicle, most often on the left side.

 

When Should You Seek a Doctor?

 

Since symptoms do not accompany varicocele, it often does not require treatment. In some cases, varicoceles are discovered during a fertility evaluation. However, you should see a doctor if you notice any of the following.

  • Pain or swelling in the scrotum
  • Discover a mass on the scrotum
  • You are having a problem with your fertility
  • When you notice that one of your testicles is larger than the other

 

For more information on vein and vascular treatment please visit our YouTube Channel.

Signs and Symptoms of Varicoceles2022-04-29T16:45:32-07:00

Process of being diagnosed with Peripheral Arterial Disease

2022-04-28T19:14:18-07:00

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 artery 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:

peripheral arterial disease

Detailed Physical Exam

To help diagnose Peripheral Arterial Disease, 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 and diagnose peripheral arterial disease. 

 

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.

For more information on Vein and Vascular conditions, please check out our Youtube Channel.

Process of being diagnosed with Peripheral Arterial Disease2022-04-28T19:14:18-07:00

What is Peripheral Arterial Disease (PAD)

2022-04-28T18:54:59-07:00

Peripheral artery disease is a subset of vascular disease,also referred to as peripheral arterial disease (PAD), which develops when excessive plaque buildup on the artery walls causing the narrowing of the arteries.

peripheral artery

The arteries deliver oxygen-rich blood from the heart to other parts of the body. When plaque builds up, it usually restricts the flow of blood, oxygen, and glucose. The obstruction causes pain in the leg as the muscles and tissues are starved for oxygen and other nutrients from the blood. While the pain usually occurs in your legs primarily, it can also be felt in other parts of the body, including your arms, stomach, hip, head, and kidneys.

Are You at Risk for Peripheral Arterial Disease (PAD)?

In most cases, the PAD symptoms are on the lower extremities. You may experience some pain, craping, or tiredness in your hip or leg muscles when climbing stairs or walking. However, the pain usually goes away with rest, only to resurface when you start walking again. Individuals suffering from peripheral arterial disease are at a high risk of coronary artery disease, stroke, or heart attack. Even worse, if left untreated, the condition can lead to gangrene and amputation.

 

Peripheral Arterial Disease – Symptoms

 

The most common symptom of Peripheral arterial disease is claudication. The fat and cholesterol build up on the artery walls cause a lack of blood flow, causing a condition referred to as ischemia. Ischemia is a condition that results when there is a greater demand for oxygen than the supply.

Claudication is a condition that causes cramping in the legs and buttocks. As mentioned, the pain and clamping flares up when you start to walk and subsides when you rest. Intermittent claudication affects about 50 percent of individuals suffering from peripheral artery disease. Some of the other common symptoms include loss of hair around the ankles, numbness or coldness in your feet.

Pain and cramping while walking may lead to a more sedentary lifestyle, meaning that the individual will burn few calories and add weight. An increase in weight also increases cholesterol, blood pressure, and other heart disease risk factors. The claudication severity often varies from mild discomfort to debilitating pain, making it hard for you to walk or perform other types of physical activities. 

PAD

Other common symptoms of the peripheral arterial disease include;

  • In extreme cases, an open wound or ulcer occurs on your toes or feet. These extreme cases lead to non-healing ulcers. The ulcer can progress to gangrene, making it hard for you to walk. In such a scenario, immediate medical attention is necessary.
  • Weakness or numbness in your legs
  • Coldness in your lower feet, especially when you find one foot is colder than the other one.
  • Experiencing pain in your feet or toes while you are resting
  • Sores on the legs, feet, and toes that do not heal
  • Slower toenails growth
  • Change in the color of your feet
  • Erectile dysfunction in men can be treated by prostate arterial embolization (PAE), which also treats benign prostatic hyperplasia (BPH)
  • Weak pulse in your feet or legs
  • Developing shiny skin on your legs
  • Having pain in your arms, especially when writing, knitting, or performing manual tasks

As the peripheral disease progresses, you may start to experience pain even when you are lying down. In extreme cases, the pain becomes intense enough to distract your sleep. Resting your legs by hanging them at your bed edge or walking around the room helps stimulate blood flow, relieving the pain temporarily.

 

What is Peripheral Arterial Disease (PAD)2022-04-28T18:54:59-07:00

Varicose Veins: Patient Transformations Part 2

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

What are varicose veins?

Varicose Veins are the twisted, bulging veins just beneath the surface of the skin. They are swollen, twisted veins that you can see just under the surface of the skin. These veins usually occur in the legs, but they also can form in other parts of the body, and are very common.

Varicose veins are caused by leaky vein valves, which allow blood to pool within the veins causing them to stretch and become enlarged. They can be an isolated finding, but the majority of the time, they are caused by underlying venous reflux disease. Venous reflux disease is also known as venous stasis, venous insufficiency or venous incompetence. Reflux may occur in the deep and/or superficial leg veins.

What are the symptoms?

The symptoms can include:

  • Aching, tenderness
  • Heaviness, fatigue
  • General restlessness in the legs
  • Burning pain
  • Throbbing pain
  • Itching
  • Leg cramps, particularly at night
  • Ankle swelling
  • Skin discoloration at the ankle
  • Skin ulcers above the ankle

Over time, complications can develop from untreated veins. These include:

  • Superficial phlebitis (painful inflammation of the vein)
  • Superficial thrombophlebitis (blood clots within the varicose veins)
  • Spontaneous vein hemorrhage (the vein can rupture spontaneously)
  • Skin discoloration and eczema around the ankle (venous eczema)
  • Skin sores or ulcers usually near the ankle

Duplex ultrasound technology is used to evaluate the veins beneath the surface of the skin. The ultrasound allows us to see if the valves are leaky; it can detect the direction of blood flow and also detects blockages in the veins, for example from blood clots or scars within the veins from previous clots. The ultrasound will determine exactly which veins are ‘bad’ or incompetent. Reflux may be detected in the deep veins (within the muscle), the great and small saphenous veins, and/or branches of the saphenous veins. This will help determine the treatment plan.

La Jolla Vein Care Before and After Transformations:

At La Jolla Vein Care, we are here for our patients from beginning to the end. We love seeing the transformations that take place. Below are a few cases from our patient transformations from before varicose vein treatment to after vein treatment.

varicose veins varicose veins varicose veins varicose veins 9 BA VV varicose 121914 1 fotor scaled 1 10 BA VV varicose DSCF0023 fotor scaled 1

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

Varicose Veins and Swelling

2022-04-28T14:48:10-07:00

Varicose Veins and Swelling

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

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

swelling

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

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

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

Varicose Veins and Swelling2022-04-28T14:48:10-07:00

29, 4, 2022

What is VenaCure?

2022-04-15T15:42:25-07:00

VenaCure is an endovenous laser ablation (EVLA) procedure for backwards flow (or “reflux”) in your saphenous vein(s).

VenaCure Laser is also referred to as endovenous laser ablation therapy (EVLT). 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 VenaCure treatment work?

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

venacure

The VenaCure procedure is performed with local anesthesia, but many patients elect to use a mild oral sedative (Valium), which is taken after checking in and completing all paperwork.

You will change into a gown and leave underwear on. Depending on the vein to be treated, you will lay on your back or on your belly.  We do our best to make special accommodations (for example, if you cannot lie flat or cannot bend a knee very well) with body positioning and using pillows.  We will do our best to make you comfortable. Then, we will give you the option of watching a movie on Netflix or listen to music. Once you are comfortable, your leg (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 laser catheter under ultrasound guidance.  Your doctor will then use a needle to administer a combination of cool saline and local anesthetic around the vein.  This solution numbs the vein and insulates it from the surrounding tissue.  Laser energy will then be used to painlessly treat the vein.

Videos of the treatment, as well as after care instructions can be found on our website and our YouTube channel.

What is VenaCure?2022-04-15T15:42:25-07:00

Understanding Venous Disease: Venous Ulcers

2022-04-23T14:20:59-07:00

Understanding Venous Disease: Venous Ulcers

A venous leg ulcer is the most severe form of chronic venous insufficiency.  This is referred to as a ‘venous leg ulcer.’  Venous ulcers of the leg 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 ulcers on the leg 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.

venous ulcer

Before and after treatment of a venous ulcers.

Copyright @ La Jolla Vein Care.

venous ulcer

Venous leg ulcers make up 70% of all chronic leg wounds. They usually occur in the inner ankle or outer ankle locations.

The treatment of venous leg ulcers is to correct the underlying problem: the faulty veins. Treatment of the underlying non-functional veins will reduce pressure from venous hypertension, allowing the wound to heal.  There are a number of non-surgical treatment options that can accomplish this including foam sclerotherapy and endovenous ablation, depending on the affected veins. To determine if your leg wound is related to a vein problem or for treatment options, call us for more information.

Understanding Venous Disease: Venous Ulcers2022-04-23T14:20:59-07:00

La Jolla Vein and Vascular welcomes Jodi Hirsch, PA-C

2022-04-23T14:24:17-07:00

La Jolla Vein and Vascular welcomes Jodi Hirsch, PA-C

jodihirsch

Jodi Hirsch PA-C is a board-certified physician assistant who has spent her career specializing in the field of peripheral vascular disease and venous disease.  She gained her undergraduate degree in chemistry and pursued her degree in Physician Assistant Studies from Touro University in NY in 2006. She has spent her professional career in San Diego, previously working in the Department of Vascular Surgery at Scripps. When not at work, she enjoys spending time with her husband and two little boys.

For more information please watch Jodi’s video here.

La Jolla Vein and Vascular welcomes Jodi Hirsch, PA-C2022-04-23T14:24:17-07:00

La Jolla Vein & Vascular welcomes Dr. Elliot DeYoung, M.D.

2022-04-23T14:16:23-07:00

La Jolla Vein & vascular welcomes our newest doctor at the La Jolla location, Dr. Elliot DeYoung, MD.

new doctor

Dr. Elliot DeYoung is a board-certified interventional radiologist who has spent his career focused on minimally invasive procedures. He completed his training at University of California, San Diego where he specialized in vascular interventions and served on the patient safety committee. Dr. DeYoung’s expertise spans vascular disease from angioplasty and stenting to embolization and ablation. He values thorough patient education and the continuity of patient care.

Dr. DeYoung is excited about joining La Jolla Vein & Vascular team to continue its renowned venous care. He will lead the center in the expansion of vascular services to provide crucial out-patient care to the community. The practice is enthusiastic to offer treatments for peripheral arterial disease, may thurners, and uterine fibroids.

Dr. DeYoung received his bachelor’s degree from USC in Psychology followed by his medical degree from the University of Sydney, School of Medicine. He initially trained as a General Surgery resident in New York before transitioning his training to Interventional Radiology in San Diego. He has a passion for water sports and his free time is spent enjoying the outdoors with his family.

Dr. DeYoung is looking forward to treating your vascular needs at La Jolla Vein & Vascular.

Dr. DeYoung is a vascular specialist with focus on aortic and peripheral vascular disease, pelvic congestion syndrome, and interventional oncology. His skills include varicocele embolization, venous interventions, uterine fibroid embolization, prostate artery embolization, and genicular artery embolization.

Please check out Dr DeYoung’s video for more information.

La Jolla Vein & Vascular welcomes Dr. Elliot DeYoung, M.D.2022-04-23T14:16:23-07:00

Two Venous Reflux Disease Treatments for visible bulging veins

2022-04-15T15:32:43-07:00

 

Two Venous Reflux Disease Treatments for visible bulging veins include: 

 

Asclera, and Phlebectomy. We at La Jolla Vein Care offer a variety of methods for vein disease. Below is some helpful information about both procedures. 

 

Ultrasound-guided foam sclerotherapy works well for treating surface varicose veins and veins that are not visible to the naked eye. The foam medication can be seen on ultrasound, which allows us to administer it precisely and direct it towards nearby varicose veins. Foam sclerotherapy can be safely used for bulging veins that travel close to the skin or nerves. It also travels easily through veins with many twists and turns.

Asclera for bulging veins:

A variety of sclerosant medications can be used for veins, but we prefer polidocanol (brand name Asclera®) because it is the most comfortable for the patient and has the lowest risk of side effects. It is a detergent-type medication that injures the inner lining of the veins. This causes the vein to stop flowing, then eventually close down completely. Polidocanol has been well-studied and has been approved by the FDA since 2010 for the treatment of varicose veins and has been used in Europe for decades. Polidocanol is turned into a foam to treat larger veins. This is an off-label use of the sclerosant but very effective and well tolerated. La Jolla Vein Care providers have extensive experience with foam sclerotherapy for the treatment of bulging veins. 

How many treatments will I need?

The number and frequency of treatments depends on a patient’s anatomy, how well the veins respond to each treatment, and the patient’s treatment goals. The national average is 2 to 5 treatment sessions to achieve 80% improvement. Some larger or resistant veins require two or more treatments to respond completely.

Phlebectomy Procedure: 

Phlebectomy is the surgical removal of bulging veins though tiny skin incisions. This minimally invasive procedure is performed in the office with local anesthesia. Phlebectomy is also known as micro phlebectomy (because the incisions are tiny) or ambulatory phlebectomy.

WHAT ARE THE OPTIONS FOR TREATING BULGING  VEINS AT THE SKIN SURFACE?

There are two main techniques to treat varicose veins:

1.) Phlebectomy: surgical removal of the veins

2.) Foam sclerotherapy: injection of a medicated foam to close the veins

Sclerotherapy is the least invasive, but patients with large and/or numerous bulging veins may require several sclerotherapy appointments over two or more months. This is because we can only administer a small amount of foam medication per day and larger veins may require two or more injections to close. Larger veins can also become firm and tender after sclerotherapy and/or deposit brownish blood pigments in the skin as the veins are healing.

WHY WAS I OFFERED PHLEBECTOMY?

Patients with bulging varicose veins may prefer to start with micro-phlebectomy removal of the largest veins, then sclerotherapy treatment for the remaining veins. This reduces the number of appointments and accelerates recovery.

Phlebectomy

HOW DOES THE PROCEDURE WORK?

The skin is numbed with lidocaine, then a tiny puncture is made in the skin (about half the size of a grain of rice). We then infuse additional numbing medication around the veins. A small hook is used to bring the vein to the skin surface, then the vein is removed.

 

Two Venous Reflux Disease Treatments for visible bulging veins2022-04-15T15:32:43-07:00
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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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