10, 1, 2023

Varicose Veins 101

2022-12-26T11:31:21-08:00

Varicose veins are swollen, blue, bulging, twisted, superficial (those closest to the skin) veins of the leg. High pressure inside the superficial veins of the leg causes varicose veins, but genetics are thought to play a large, contributing role. As many as 40 million Americans have them. Left untreated, varicose veins may become worse. Persons with varicose veins often experience leg aches and fatigue. They may also incur skin changes such as rashes, redness and ulcers.

What factors influence development of varicose veins?

  • Age: People between the ages of 30 and 70 often have varicose veins. 
  • During pregnancy, 50 to 55 percent of American women experience varicose veins. In most cases, the veins return to normal within a year after childbirth.
  • Women who have multiple pregnancies may develop permanent varicose veins.  

Risk factors include:

o being overweight, or a family history of varicose veins

o standing or sitting for long periods of time

A vascular surgeon will review your medical history, do a physical exam and look at your prominent veins. You may be sent for a duplex ultrasound test, also known as a venous reflux study, to identify the causes of your varicose veins. The painless test uses high-frequency waves to measure the venous blood flow. The test helps the physician visualize the vein structure and the blood flow in the veins.

Most doctors will suggest lifestyle changes for patients. This includes:

  • maintaining the proper weight
  • elevating legs when resting
  • not sitting or standing for long periods of time 
  • wearing compression (elastic support) stockings

In some cases, a vascular surgeon will recommend additional treatments:

  • Sclerotherapy is the sealing of the veins via an injection of a medication. This procedure is done mainly for smaller spider veins. It is performed in a doctor’s office. The physician injects a chemical into the varicose veins to prevent the veins from filling with blood.
  • Vein Stripping is performed. The physician may make two small incisions, one in the groin area and another below the knee, through which the diseased veins are removed. This is an outpatient procedure, usually done under general anesthesia. Patients can resume their normal activities after four weeks.
  • Ablation and laser treatment are performed on patients with severe varicose veins. They are done under local or general anesthetic. The ablation procedure inserts a thin, flexible catheter into the leg vein. The tip of the catheter has tiny electrodes that heat and seal off the walls of the vein. Laser treatments use a tiny fiber placed in the vein through a catheter. The fiber sends out laser energy that closes the diseased portion of the vein. These two modes of treatment frequently replace stripping of the saphenous vein. They can be performed alone or in conjunction with removal of individual clusters of the veins known as small incision avulsion or ambulatory phlebectomy.

 

“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. 

 

Varicose Veins 1012022-12-26T11:31:21-08:00

Meet our team of vein & vascular specialists: Dr DeYoung

2023-01-30T10:44:03-08:00

Our vein specialists and radiologist 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.

Dr. Elliot DeYoung 

Interventional Radiologist

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, and genicular artery embolization.

“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 DeYoung2023-01-30T10:44:03-08:00

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

La Jolla Vein & Vascular Health Mission

2022-12-26T10:53:29-08:00

Expert Healthcare

Our clinical staff consists of Registered Vascular Technologists (RVTs), Nurse Practitioners and Medical Assistants and ancillary staff who have several years of experience in vein and vascular care and health. Most of our staff have helped patients at La Jolla Vein & Vascular for 5+ years.  We also have administrative staff with expertise in insurance preauthorizations, and in combination with our doctors, will fight for patients to get the treatment they need.

Because of our staff’s extensive experience in vein health & care, they are knowledgeable about vein conditions and treatment and are happy to answer questions any time.

health

La Jolla Vein & Vascular Health Values

OUR MISSION

OUR MISSION IS TO PROVIDE OUR EXPERTISE AND SPECIALIZED TRAINING TO IMPROVE YOUR VASCULAR HEALTH, IN A ONE-STOP CONVENIENT SETTING.  OUR COMPREHENSIVE VEIN CARE AND VASCULAR CLINIC HELPS PATIENTS TAKE CONTROL OF THEIR VASCULAR HEALTH.

“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. 

health

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. 

La Jolla Vein & Vascular Health Mission2022-12-26T10:53:29-08:00

30, 12, 2022

What you need to know about Carotid Artery Disease

2022-10-24T14:55:36-07:00

What is carotid artery disease? 

Your carotid arteries are two main arteries that carry blood from your heart, up through your neck, to your brain. Healthy carotid arteries are smooth and unobstructed, allowing blood to flow freely to the brain and provide oxygen, glucose and other nutrients that your brain cells need. Carotid artery disease is a vascular disease.

Typically with age, the carotid arteries build up plaque, made up mostly of fat and cholesterol. Plaque narrows the insides of the arteries and makes them stiff. This process is commonly referred to as “hardening of the arteries,” or atherosclerosis. Carotid artery disease results when the carotid arteries become narrow or obstructed and provide a risk of the plaque traveling to the brain and causing a stroke.

What is a stroke?

Strokes are the third leading cause of death in the United States and the leading cause of perma- nent disability in older Healthy Plaque Build Up adults. Approximately 25% of strokes occur when bits of carotid plaque or clot break off and flow to the brain. If left untreated, carotid artery disease may lead to stroke, where lack of oxygen and other essential nutrients cause damage to the brain. Depending on its severity, a stroke can be fatal.

Symptoms of carotid artery disease: 

  • There may be no symptoms in the early stages of carotid artery disease, and stroke could be the first sign of the condition.
  • Stroke, however, typically has warning signs, referred to as mini-strokes or transient ischemic attacks (TIAs).
  • Mini-stroke symptoms are usually temporary, lasting a few minutes to a few hours, and should be treated as serious medical emergencies requiring immediate treatment because they are strong predictors of future stroke.

Some symptoms of stroke or TIA may include:

– Weakness, numbness, or tingling on one side of the body

– Inability to control movement of a body part

– Loss of vision or blurred vision in one or both eyes

– Inability to speak clearly

– Difficulty talking or comprehending what others are saying

Causes and risk factors of carotid disease:

  • High blood pressure and age
  • Diabetes
  • Smoking
  • High cholesterol and obesity
  • Lack of exercise
  • Family history of hardening of the arteries and/or stroke

Diagnosis of carotid artery disease: 

If your doctor suspects carotid artery disease, it can be confirmed by undergoing a noninvasive duplex ultrasound examination. The ultrasound can also show how severe the disease is. If you experience symptoms of a mini-stroke, seek medical attention immediately. Your physician may then ask you to see a vascular specialist since they are highly trained in every type of vascular procedure.

Treatment:

Depending on the severity of your condition, treatment options may include lifestyle changes, medications, or procedures such as carotid endarterectomy (cleaning out the plaque with surgery), or in select cases, carotid artery stenting. Some patients benefit from surgery even if they are having no symptoms based upon life expectancy and degree of narrowing.

La Jolla Vein & Vascular runs  the diagnostic ultrasound for Carotid Artery Disease, but will refer out for further treatment.

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 you need to know about Carotid Artery Disease2022-10-24T14:55:36-07:00

What is Asclera?

2022-10-24T13:02:52-07:00

What is polidocanol (Asclera)?

A variety of sclerosant medications can be used for veins, but at La Jolla Vein Care, we prefer polidocanol (brand name Asclera), because it is the most comfortable for the patient and has the lowest risk of side effects. It is a detergent-type medication that injures the inner lining of the veins. This causes the vein to stop flowing, then eventually close down completely. Polidocanol has been well-studied and has been approved by the FDA since 2010 for the treatment of varicose veins and has been used in Europe for decades. Polidocanol is turned into a foam to treat larger veins. This is an off-label use of the sclerosant but very effective and well tolerated. Asclera (polidocanol) Injection is a prescription medicine that is used in a procedure called sclerotherapy to remove unwanted veins on your legs. It is administered by a healthcare provider to treat two types of veins:

Uncomplicated spider veins (very small varicose veins ≤ 1 mm in diameter)

Uncomplicated small varicose veins (1 to 3 mm in diameter) known as reticular veins

Asclera has not been studied in varicose veins more than 3 mm in diameter. La Jolla Vein Care providers have extensive experience with foam sclerotherapy.

Patient Results before and after at 26 weeks after last treatment

The patient was treated for uncomplicated spider veins (≤ 1 mm)

Treated with 0.5% Asclera

ADVERSE REACTIONS:

-Injection site hematoma

-Injection site irritation

-Injection site discoloration

-Injection site pain

-Injection site itching

-Injection site warmth

-Neovascularization

-Injection site clotting

How often do I need treatment to see results?

The number and frequency of treatments depends on the size of the vessels and their location. Ask your provider about an individualized treatment approach that is right for you.

How does Asclera work?

Asclera is a sclerosing agent that is injected into the vein. It works by damaging the endothelium, the inside lining of blood vessels. This causes blood platelets and cellular debris to attach to the lining of the vessels. Eventually, cellular debris and platelets cause the blood vessel to clot. Over time, the clotted vein will be replaced with tissue.

How satisfied are patients who use Asclera?

88% of clinical study patients were satisfied or very satisfied with their Asclera treatment after 12 weeks.

How long is each Asclera session?

A typical session lasts 15 to 45 minutes. Generally, 1 to 3 injections may be necessary to treat a given spider or reticular vein. Repeat treatment sessions may be necessary. Any additional treatment sessions are usually separated by 1 to 2 weeks.

What should I expect after being treated with Asclera?

Following treatment, you’ll need to wear compression stockings day and night for 2 to 3 days, then for 2 to 3 weeks during the daytime, as directed by your provider. Compression stockings are designed to apply pressure to your lower legs, helping to maintain blood flow, and reduce discomfort and swelling. Compression helps your legs heal and is necessary to reduce the risk of deep vein thrombosis.

Are there activities I should avoid after receiving an Asclera Injection?

For 2 to 3 days following the treatment, avoid:

-Heavy exercise

-Sunbathing

-Long plane flights

-Hot baths, hot tubs, or saunas

Possible side effects to Asclera treatments:

Temporary side effects may occur at the site of the injection, including:

-Bruising

-Raised red areas

-Small skin sores

-Darkened skin in the form of lines or spots

-Multiple tiny red blood vessels

-These side effects usually go away within a few days to several weeks. Some side effects may take months or years to resolve.

For more information or to book an appointment for Asclera therapy, please call our office at 858-550-0330.

 



What is Asclera?2022-10-24T13:02:52-07:00

Uterine Fibroids: what you need to know

2022-10-24T12:48:30-07:00

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.

 

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. 


Uterine Fibroids: what you need to know2022-10-24T12:48:30-07:00

La Jolla Vein & Vascular treatments for varicoceles

2022-10-24T12:20:15-07:00

La Jolla Vein and Vascular Treatments for Varicoceles 

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

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

Some of the clear indications that you need varicoceles repair during adolescence include pain, progressive testicular atrophy, and abnormal semen analysis results. While this treatment helps in improving sperm characteristics, it is not clear whether untreated varicoceles can lead to progressive sperm worsening. The common varicoceles treatment options include (La Jolla Vein & Vascular Only Performs Varicocele Embolization):

Percutaneous Embolization (Varicocele Embolization)

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

Catheter-directed Embolization

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

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

Efficacy of Embolization for Varicoceles 

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

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

Varicocelectomy

Your doctor will make a small 1-inch incision into your scrotum and use a microscope or magnifying glass to see the veins better. The doctor might use local anesthesia to numb the area. General anesthesia can also help you sleep through the procedure.

Laparoscopic Surgery

This procedure involves making a much smaller incision and inserting a tube that holds the surgical tools. The surgeon will also use a special camera to see inside you. The procedure is done under general anesthesia to help you sleep through the procedure. The results from the other treatments are similar, only that the incision is small with laparoscopic surgery.

Open Surgery

The open surgery treatment is usually done on an outpatient basis and using a local or general anesthetic. The surgeon will make a small incision below your groin or abdomen to access the affected vein. Your doctor uses advanced surgical tools such as Doppler ultrasound and a surgical microscope to help guide the procedure. The patient can return to a regular daily routine after two days.

Recovery

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

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

 

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 treatments for varicoceles2022-10-24T12:20:15-07:00

30, 11, 2022

Your height & varicose veins

2022-10-24T11:41:31-07:00

Does height play a role in developing varicose veins? Yes. We initially presented this information in 2018, after a study at Stanford University School of Medicine found a person’s height to be a significant risk factor for developing varicose veins. “We not only found an association between height and varicose veins, but the genetic studies we did showed a causal link,” said cardiologist and study author Dr. Nicholas Leeper, an associate professor of surgery and cardiovascular medicine at Stanford. “That suggests that the genes and pathways that drive human height are also likely to be causing varicose veins.” The study originally published in 2018, found a significant link between above-average height and vein health. In this population-based study of ~500,00 individuals, greater height appeared as a novel predictor of varicose vein disease in machine learning analyses, and was independently associated in multivariable-adjusted Cox regression.

Other known influences such as age, excess weight, being female, and genetics also play a role in the development of them. This study reveals that taller individuals, the study concluded, have a greater chance of developing them and possibly even blood clots in the legs.

The reason has to do with gravity — blood from the legs of taller people must travel a greater distance to the heart, which forces the veins to work harder. But it also has to do with genetics. The study’s authors found above-average height was not only associated with varicose veins, but could be the underlying cause of the swollen veins that rise to the surface of the legs and feet as well.

Lifestyle modifications to reduce the risk of developing them by including use of compression stockings when traveling and sitting or standing for longer periods of time, exercise, weight loss (if indicated), and leg elevation. Read about measures to reduce symptoms related to varicose veins.

Original Study Published in Circulation.

Clinical and Genetic Determinants of Varicose Veins: A Prospective, Community-Based Study of ~500,000 IndividualsEri Fukaya, Alyssa M. Flores, Daniel Lindholm, Stefan Gustafsson, Daniela Zanetti, Erik Ingelsson, Nicholas J. LeeperCirculation.

 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. 

 

Your height & varicose veins2022-10-24T11:41:31-07:00

What you need to know about abdominal aortic aneurysm

2022-10-24T14:50:55-07:00

What is an abdominal aortic aneurysm (AAA)?

The aorta, the largest artery in your body, runs from your heart, down through your chest, and into your abdomen. The abdominal region of the aorta is responsible for delivering blood to your legs, GI tract and kidneys.

An abdominal aortic aneurysm (AAA) occurs when the wall of the aorta progressively weakens and begins to bulge. An AAA may continue to enlarge and eventually rupture if left untreated, causing severe internal bleeding and possibly death. Nearly 200,000 people in the United States are diagnosed with A A A annually; approximately 15,000 die each year from a ruptured AAA.

In addition to concerns about rupture, clots or debris may also develop within an AAA. These substances can be carried to other areas in the body and block circulation, causing severe pain or possibly limb loss if blood flow is cut off for too long.

AAA can be safely treated with early diagnosis; however, most patients have no symptoms.

Causes and Risk Factors:

Most aortic aneurysms are caused by a breakdown in the proteins that provide structural strength to the wall of the aorta. Some risk factors that contribute to this structural breakdown include:

  • Age—individuals over 60 years are most likely to develop the condition
  • Gender—males are more prone to the condition than females
  • History of atherosclerosis (hardening of the arteries) • Family history of AAA
  • Smoking
  • High blood pressure

Symptoms:

Most people feel no symptoms, and an abdominal aortic aneurysm is often detected when tests are conducted for other unrelated reasons. Those who do have symptoms commonly describe back pain, pulsations in the abdomen, groin pain or sometimes sores on the feet.

Diagnosis

If an abdominal aortic aneurysm is suspected, you likely will be referred for an abdominal ultrasound, a painless, safe test that can screen for and measure the size of an AAA. Computed tomographic angiography (CTA) can assess aneurysm size, location and the extent of impact. This study requires exposure to radiation and injection of an intravenous contrast agent. However, a CTA provides valuable anatomic information and can help your vascular surgeon determine the optimal type of repair.

Medicare Screening Benefit

Medicare offers a free, one-time AAA ultrasound screening for qualified seniors as part of their Welcome to Medicare physical during the first 12 months of their enrollment. Men who have smoked sometime during their life and men and women with a family history of AAA are eligible for this benefit.

Treatment

Vascular surgeons can determine the best procedure for you, based on the size of your aneurysm and other factors. For smaller AAAs, you may need to make lifestyle changes, such as quitting smoking and lowering blood pressure. You may be prescribed medication. Your surgeon will have you come back for regular checkups to see if the AAA has changed.

For large AAAs, or those that have been increasing in size over time, repair may be carried out either by placement of an endovascular stent graft or by open bypass grafting.

Be sure to see a board certified vascular surgeon. They have specific training in both minimally invasive and traditional open repairs. The type of repair conducted is very important to long term durability and freedom from rupture.

La Jolla Vein & Vascular runs  the diagnostic ultrasound for AAA, but will refer out for treatment.

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 you need to know about abdominal aortic aneurysm2022-10-24T14:50:55-07:00
Go to Top