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3, 5, 2022

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

25, 4, 2022

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

A deeper look into chronic venous insufficiency

2022-04-15T15:36:06-07:00

What is chronic venous insufficiency?

Chronic venous insufficiency (CVI) is an inflammatory condition caused by long standing, untreated venous reflux disease.  Commonly, venous reflux disease causes a collection of symptoms such as leg swelling, heaviness, fatigue and varicose veins. But, over time, when blood is no longer circulating properly in the leg veins, skin changes can also appear. When skin changes appear, this is termed, chronic venous insufficiency (CVI). Venous stasis is another term used for this condition.   Chronic inflammation from CVI causes the skin around the ankles to darken, become dry, itchy, and firm. In severe cases, the skin can start to break down and ulcerate. The ulcer (wound) occurs in the inner or outer ankle and is also referred to as a stasis ulcer or venous ulcer.

Venous stasis skin changes associated with venous insufficiency include:

  • Darkening of the skin along the ankles
  • Itching and dry skin around the ankles (venous eczema)
  • Development of wounds around the ankles, called venous leg ulcers

 

Chronic Venous Insufficiency is progressive and worsens over time.

Chronic Venous Insufficiency is also known as venous stasis, or venous incompetence. Venous reflux disease refers to ‘leaky valves in the veins of the legs. Reflux may occur in the deep and/or superficial leg veins. The deep veins are those within the muscle; they bring at least 80-90% of the blood from the legs back to the heart. The superficial veins are outside of the muscle and under the skin. The main superficial veins are the Great Saphenous Vein that courses up the middle of the thigh and calf and the small saphenous vein, which courses up the back of the calf. Normally, there are one-way valves within the leg veins, which help blood flow in one direction: toward the heart. This means blood is traveling against gravity. The calf muscle also helps move blood toward the heart. When vein valves are leaky, blood flows backward (reflux) towards the feet. Blood pools in the lower legs, causing bulging veins at the surface. Symptoms include leg heaviness, leg fatigue, leg pain, ankle swelling, phlebitis (inflamed and painful veins) , restless legs at night, and night cramps. Venous reflux disease is progressive and worsens over time. Skin changes may also develop, including darkening of the skin around the ankles. The darkening of the skin is sometimes referred to as skin changes. The skin can become dry and itchy (venous eczema). Eventually, the skin can break down causing a wound, called a venous leg ulcer. 

 

A deeper look into chronic venous insufficiency2022-04-15T15:36:06-07:00

Chronic venous insufficiency and leg ulcers

2022-04-15T15:35:10-07:00

Stages of Development of Varicose

Chronic venous insufficiency (CVI) is an inflammatory condition caused by long standing, untreated venous reflux disease that causes leg ulcers.  Commonly, venous reflux disease causes a collection of symptoms such as leg swelling, heaviness, fatigue and varicose veins. But, over time, when blood is no longer circulating properly in the leg veins, skin changes can also appear. When skin changes appear, this is termed, chronic venous insufficiency (CVI). Venous stasis is another term used for this condition.  

Chronic inflammation from CVI causes the skin around the ankles to darken, become dry, itchy, and firm. In severe cases, the skin can start to break down and ulcerate. The leg ulcers or (wounds) occur in the inner or outer ankle and is also referred to as a stasis ulcer or venous ulcer.

Venous stasis skin changes associated with venous insufficiency include:

  • Darkening of the skin along the ankles
  • Itching and dry skin around the ankles (venous eczema)
  • Development of wounds around the ankles, called venous leg ulcers

HOW IS CVI TREATED?

The treatment of CVI cannot reverse the skin changes but it can prevent it from worsening and ulceration. In our experience, treatment of underlying venous reflux reduces the inflammatory changes and the skin may become less itchy and dry, but the permanent skin discoloration does not disappear. Treatment involves correction of the underlying venous reflux, which can help decrease leg ulcers.

HOW ARE LEG ULCERS TREATED?

Venous leg ulcers, depending on the severity, can be healed with a combination of correction of the underlying venous reflux, wound care clinic referral, and compression therapy. A detailed ultrasound will determine what specific treatment is needed depending on where the underlying reflux lies (for example, in the saphenous veins, perforator veins and tributaries). Deep vein reflux is also present in many individuals with ulcers.

leg ulcers

4 BA VLU ulcer DSCF9906 fotor

5 BA VLU ulcer foam results 6 fotor

Chronic venous insufficiency and leg ulcers2022-04-15T15:35:10-07:00

Varicose Veins Before & After: Patient Transformations Part 1

2022-04-15T15:34:00-07:00

What are varicose veins?

varicose

Varicose veins are the twisted, bulging veins just beneath the surface of the skin. Varicose veins 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.

Varicose veins are caused by leaky vein valves, which allow blood to pool within the veins causing them to stretch and become enlarged. Varicose veins 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.

In our study, led by Dr. Nisha Bunke and published in the Journal of Vascular Ultrasound in 2018, we studied over 1,000 legs with this vein disease. Over 90% of the time, the source of the varicose veins were the great and small saphenous veins. The Great Saphenous Vein (GSV) courses up the middle of the thigh and calf and the small saphenous vein (SSV), which courses along the back of the calf. Normally, there are one-way valves within the leg veins, which help blood flow in one direction: toward the heart. This means blood is traveling against gravity. The calf muscle also helps move blood toward the heart. When vein valves are leaky, blood flows backward (reflux) towards the feet. Blood pools in the lower legs, causing bulging veins at the surface. 

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 treatment.

pt1

pt2

pt3

 

Varicose Veins Before & After: Patient Transformations Part 12022-04-15T15:34:00-07:00

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

What is VenaSeal?

2022-04-15T11:21:27-07:00

The U.S. Food and Drug Administration (FDA) approved the VenaSeal Closure System to permanently treat varicose veins by sealing the affected superficial veins using an adhesive agent.

vseal

The VenaSeal Closure System is a unique, minimally invasive treatment that uses a safe-for-the-body medical glue to quickly and effectively treat varicose veins (venous reflux disease). Using ultrasound, a doctor will guide a tiny catheter through a small access site in the skin and into the diseased area of the vein. Next, the VenaSeal dispenser delivers a very small amount of medical glue to close the vein. Once the affected vein is closed, blood is immediately re-routed through other healthy veins in the leg.

Unlike other treatments, it does not require anesthesia to be injected into the leg via multiple needle sticks (tumescent anesthesia), and because there are no pre-procedures drugs involved, patients can return to their normal activities right after the treatment. Unlike heat-based procedures, with VenaSeal there is no risk of skin burns or nerve damage. VenaSeal usually does not require any post-treatment pain medication or uncomfortable compression stockings.

procedure

The VenaSeal closure system is the only non-tumescent, non-thermal, non-sclerosant procedure that uses a proprietary medical adhesive delivered endovenously to close the vein. This unique approach eliminates the risk of nerve injury when treating the small saphenous vein, which is a risk sometimes associated with certain thermal-based procedures. Clinical studies have demonstrated that the procedure is safe and effective.

Call La Jolla Vein Care at 858-550-0330 to find out if VenaSeal is a good option for your vein treatment!

Check out our youtube channel for more information on VenaSeal.

 

What is VenaSeal?2022-04-15T11:21:27-07:00

Spider Veins Before and After Patient Transformation

2022-04-13T11:56:42-07:00

What are spider veins?

They are the fine, thread-like reddish veins at the surface of the skin, and are often considered a cosmetic issue, but they can be associated with underlying feeder veins, not visible to the naked eye.  Feeder veins are the ‘blue veins’ also known as ‘reticular veins,’ that give rise to spider veins. They may also be a sign of underlying venous insufficiency. For example, they are usually located in the inner ankles and inner thighs can indicate an underlying problem with the saphenous vein. As a result, an ultrasound examination may be recommended to identify and effectively treat the underlying source.

What are the symptoms?

Vein conditions affect people differently. For some, they can be a painless cosmetic concern, and for others they may cause symptoms. The most common symptoms are burning, throbbing, and localized pain. They can also feel hot and itchy and bleed.

What are the causes?

They are caused by the same condition that causes varicose veins. Leaky vein valves allow blood to pool within the veins causing them to stretch and become enlarged. Spider veins on other areas of the body, such as the face, and chest can be caused by sun damage, hormone changes or liver disease. Hormones, such as with pregnancy, birth control or hormone replacement therapy can weaken the vein wall.

Spider veins and reticular veins of the legs are most commonly treated with sclerotherapy. Sclerotherapy involves an injection of a medication into the vein.  This will cause the vein to collapse and gradually fade away. Sclerotherapy has been used to treat spider veins for decades, but modern solutions such as Asclera, allow for spider veins to be treated with minimal discomfort and immediate return to activities.

 

Below are La Jolla Vein Care patient transformations before and after vein treatment for spider veins. 

spider veins

spiderveins2

spider veins

Spider Veins Before and After Patient Transformation2022-04-13T11:56:42-07:00

3 Venous Reflux Disease Treatments for underlying vein reflux

2022-04-12T10:08:56-07:00

3 Venous Reflux Disease Treatments for underlying vein reflux:

 

The ClariVein procedure

When someone is diagnosed with underlying vein reflux disease, the ClariVein procedure is for the 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 for vein reflux disease.  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 underlying diagnosis of vein reflux disease, which can cause a  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.

 

3 Venous Reflux Disease Treatments for underlying vein reflux2022-04-12T10:08:56-07:00
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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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