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11, 4, 2022

What is ClosureFast?

2022-04-11T10:20:19-07:00

ClosureFast an endovenous radiofrequency ablation (RFA) procedure

The procedure  ClosureFast, is for the backward flow of blood (or “Venous reflux”) in your saphenous vein(s). The great saphenous veins and small saphenous veins are the two main superficial veins of the leg. They run along the inner leg and the back of the leg, respectively. This minimally invasive procedure can be performed in the office in less than an hour and patients usually return to their usual level of activity the same day.

closurefast1

How does the ClosureFast 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 should I expect on the day of treatment?

closurefast2

ClosureFast is performed with local anesthesia, but many patients elect to use a mild oral sedative (Valium), which is taken after checking in and completing all paperwork.  You will change into a gown and leave underwear on.  Depending on the vein to be treated, you will lay on your back or on your belly.  We do our best to make special accommodations (for example, if you cannot lie flat or cannot bend a knee very well) with body positioning and using pillows.  We will do our best to make you comfortable.  Then, we will give you the option of watching a movie on Netflix or listening to music.  Once you are comfortable, your leg (s) will be prepped with a cleansing solution for the sterile procedure.  The doctor will perform an ultrasound to map the vein (s) to be treated.  Then, a numbing agent (lidocaine) will be injected into the skin. In the numb area of the skin, a tiny puncture is made to pass the radiofrequency catheter.  Your doctor will then use a needle to administer a combination of cool saline and local anesthetic around the vein either in the thigh or calf (depending on which vein is treated).  This solution numbs the vein and insulates it from the surrounding tissue.  After the numbing solution is applied, the vein is painlessly treated with radiofrequency energy.

Once your vein has been treated, we will clean your leg and apply a compression stocking which you will wear for 72 hours continuously.  You will walk for 30 minutes prior to getting in your car.

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

 

What is ClosureFast?2022-04-11T10:20:19-07:00

What is Asclera?

2022-12-13T13:07:15-08:00

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. 

 

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.

You can visit the Asclera website here.

 

What is Asclera?2022-12-13T13:07:15-08:00

How Cholesterol Affects Your Vascular Health

2022-04-05T12:23:27-07:00

How cholesterol affects your vascular health

When it comes to vascular disease, cholesterol is enemy number one. Cholesterol is a waxy, fat-like substance found in the walls of human cells. The human body produces cholesterol but it also comes from foods that are high in animal fats such as eggs, cheese and meat.

But all cholesterol is not created equal. It comes in two very different types:

  • Good cholesterol, or high-density lipoprotein (HDL), helps keep arteries from becoming blocked.
  • Bad cholesterol, or low-density lipoprotein (LDL) can build up and cause blockages in the arteries.

Triglycerides are fats produced by the liver. They can cause the same kinds of health problems as LDL. Over time, a buildup of extra cholesterol, or plaque, can narrow the insides of blood vessels. Eventually, the plaque causes hardening of the arteries, also called atherosclerosis. This condition can lead to vascular disease, strokes, heart attacks, aneurysms and other life-threatening problems.

When doctors tell you to “know your numbers,” one of those numbers is your cholesterol level. For good vascular health:

  • Total cholesterol should be less than 200.
  • Good cholesterol (HDL) should be more than 60. 
  • Bad cholesterol (LDL) should be less than 130.
  • Triglycerides should be less than 150.

Why take statins for cholesterol control?

All types of atherosclerosis are improved when patients take statins.

Side effects are relatively rare, and if a patient does not tolerate one statin, there are many different ones that can be tried.

What are statins?

Statins act as a key control point in the metabolism of serum cholesterol.

Specifically, when “bad” (LDL) cholesterol is high, the risk of heart attack and stroke is high.

Can lifestyle changes impact cholesterol levels?

Yes. Even slight lifestyle choices can impact vascular disease. For example, a 10-pound weight loss can result in a 5 to 8 percent reduction in LDL.

If lifestyle changes are not enough to bring your numbers to a healthy level, medication may help. Total cholesterol levels that are borderline high (between 150-199 mg /dL) or high (200 mg / dL or more) may require treatment with a statin drug. Some conditions actually benefit from a statin even if your numbers are normal.

Who benefits from taking statins?

  • People who are at risk of heart attack and stroke due to high cholesterol
  • Patients with hardening of the arteries supplying oxygen-rich blood to the brain or the legs
  • Vascular surgery patients. During a vascular procedure, they have fewer complications

Do statins affect plaque in the blood vessels?

Newer research suggests that statins don’t just stop plaque from getting worse, they may also reduce plaque in the leg arteries. Studies also now suggest that statins keep plaque stable so it is less likely to break off and form blood clots that cause heart attacks and strokes. Statins also improve the function of cells inside of the artery.

Don’t statins have side effects?

Few statin side effects have been recorded since they were introduced 40 years ago. Most mild side effects, such as muscle pain and cramps, can be avoided by switching statins. Serious side effects are rare but it is important to be aware of them. They include:

  • Liver damage. This very rare condition doesn’t cause symptoms, so laboratory tests are ordered when patients first start taking statins.
  • A wide range of muscle injuries. In rare cases, inflammation of the muscles can occur. At its worst, this rapid muscle destruction can lead to kidney failure.

 

How Cholesterol Affects Your Vascular Health2022-04-05T12:23:27-07:00

30, 3, 2022

What is Carotid Artery Disease?

2022-03-30T16:49:46-07:00

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.

 

What is Carotid Artery Disease?2022-03-30T16:49:46-07:00

Asclera: A New Treatment For Spider Veins and Small Varicose Veins

2022-12-13T13:26:40-08:00

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

asclerabeforeascleraafter

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.

asclerabeforeafter

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.

ascleragraph
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.

Asclera: A New Treatment For Spider Veins and Small Varicose Veins2022-12-13T13:26:40-08:00

What to expect when you receive Foam Sclerotherapy

2022-03-25T12:49:38-07:00

Ultrasound-Guided Foam Sclerotherapy

 

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 veins that travel close to the skin or nerves. It also travels easily through veins with many twists and turns. 

 

Foam treatment of varicose veins is not as new as people think. It was originally described as early as 1944.  Foam sclerotherapy is a method for treating varicose veins. It involves injecting a foamed sclerosant medication into unhealthy varicose veins, causing them to eventually dissolve.

image of foam sclerosant

Colleagues in Spain attracted attention of some vein specialists and interest in the use of foam technology in treating venous insufficiency was reawakened. Administration of foamed sclerosant was reintroduced in the early 1990s by Cabrerra, who summarized a broad experience in 1997. By the 1990’s, broad use of diagnostic ultrasound imaging made it possible to monitor foam distribution with ultrasound scanning. Some 40 years earlier, and before the development of ultrasound scanning, foam had been used in Germany to treat varicose veins.  At that time, foam was made by special syringes and its distribution was assessed by touch, instead of ultrasound scanning.

foam

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. 

 

What should I expect on my treatment days?

You will sign your consent form then change into shorts provided by the office. We will clean your skin with alcohol, then use ultrasound to localize the veins. The foam medication will then be injected into your veins with a fine needle. You will elevate your legs on a wedge pillow for approximately 15 minutes. After your foam sclerotherapy treatment, we will help you into your compression stockings, then you will walk for 30 minutes prior to getting in your car. This is normal for your legs to be achy and tender to the touch after treatment. 

For more information on foam sclerotherapy, read this article.

 

What to expect when you receive Foam Sclerotherapy2022-03-25T12:49:38-07:00

What are the risks for Microphlebectomy

2022-03-22T12:47:08-07:00

MicroPhlebectomy for varicose veins 

 

A microphlebectomy is a minimally invasive procedure, which is the surgical removal of bulging varicose veins through tiny skin incisions. This procedure is performed in the office with local anesthesia. Phlebectomy is also known as micro phlebectomy (because the incisions are tiny) or it can also be referred to as ambulatory phlebectomy. A microphlebectomy is for someone who is suffering from complications from varicose veins. The complications can include persistent pain, cramping, or discoloration of the skin. 

 

Risks of Microphlebectomy:

With any procedure, there are risks. In microphlebectomy the risks are listed below:

  • There is a low risk of infection at the vein removal sites, which we minimize by using sterile technique and prophylactic antibiotics. You will start the antibiotic on the morning of your procedure and continue it for 24 hours after the procedure. 
  • As with any vein treatment, there are also very small risks of deep vein clots and nerve injury. 
  • You will have bruising where the veins were removed, which fades over about two weeks. To reduce bruising, swelling or redness, try RECOVA cream. 
  • A nerve injury to the skin.
  • Numbness or pain in the feet
  • Adverse reaction to sedative or anesthetic 
  • Severe bleeding or swelling
  • Thrombophlebitis 

 

What are the risks for Microphlebectomy2022-03-22T12:47:08-07:00

After care for Foam Sclerotherapy

2022-03-21T15:15:18-07:00

After care for foam sclerotherapy

After Treatment Care

You will be instructed on how long to wear compression stockings after treatment, depending on the size of the veins that are treated. Most patients wear thigh-high compression stockings continuously for 1-3 days, then another 7 days.

For the first 24 hours after the procedure, you should not get the area wet. But after, you may shower with the stockings on or take a quick cool shower with them off. Avoid heated showers for one week after the foam sclerotherapy treatment.

You should walk 30 minutes twice daily after treatment and move your legs frequently throughout the day with short walks and/or calf exercises. This avoids pooling of blood in the legs. Avoid prolonged sitting during the day, and when you are sitting have your legs be elevated.

Avoid direct sun exposure during the healing process. The two weeks after treatment. Using sun tan lotion after is recommended.

No swimming in public pools, lakes, or oceans for one week to reduce risk of infection.

It is normal to have aching in the treated veins. This responds well to walking, ice packs, and anti-inflammatory medications such as ibuprofen (Advil, Motrin) and naproxen (Aleve).

What to avoid after foam sclerotherapy treatment

For at least two weeks after treatment, you should avoid strenuous exercise (anything more than a brisk walk), heavy lifting, saunas or hot tubs, and leg massages. All of these dilate the superficial veins and interfere with their healing. You should also avoid airline travel for two weeks after treatment.

Possible side effects after foam sclerotherapy treatment

You will likely have some bruising over the injection sites, then the treated veins may become firm and blue. We recommend patients use the product, RECOVA cream, as this helps reduce swelling, redness, and bruising post procedure.

The skin overlying the treated veins may also develop brownish hyperpigmentation as the blood products within those veins are absorbed by the body; in some patients it can take up to a year to fade.

An uncommon complication is a blood clot within a deep vein. The risk is minimized by using ultrasound guidance and performing calf exercises throughout the procedure.

 

After care for Foam Sclerotherapy2022-03-21T15:15:18-07:00

EVLA Treatment for Varicose Veins Aftercare 

2022-03-18T15:37:25-07:00

Endovenous laser vein ablation, also known as endovenous laser therapy (EVLA), is a type of treatment for saphenous vein reflux, the underlying cause of most varicose veins. At La Jolla Vein Care, we offer ALL treatment modalities for varicose veins, not just one. Treatment is customized based on a person’s individual pattern of venous reflux (determined by ultrasound examination), personal preference, and personal health history.

 

What should I do to optimize recovery after treatment? 

 

Walking is essential to optimize recovery and avoid pooling of blood in the legs. You should walk 30 minutes twice daily during treatment and to do other calf exercises throughout the day. 

 

Thigh-high compression stockings must be worn continuously for 72 hours after each treatment and for an additional week during the day after the last treatment. This improves your recovery and reduces complications. 

 

Ice packs can be used as well as anti-inflammatory medications such as ibuprofen (Advil, Motrin) and naproxen (Aleve) for pain relief. 

 

No strenuous exercise, hot tubs, or leg massages for two weeks to allow veins to heal. 

 

Avoid airline travel for two weeks to minimize risk of deep vein clots. 

 

Avoid Saunas as these dilate the superficial veins and interfere with healing.

 

We look forward to helping you achieve your treatment goals! 

Please reach us at (858) 550-0330 with any questions. 

 

EVLA Treatment for Varicose Veins Aftercare 2022-03-18T15:37:25-07:00

The Four Best Ways to Treat Venous Disease

2022-03-17T10:25:13-07:00

Symptoms to look for in venous disease:

 

La Jolla Vein Care offers various ways for venous disease treatment. While there are numerous excellent ways to treat venous disease, we have named four of our favorite ways to treat it. What is venous disease and how does it happen? Venous disease occurs when backwards flow (or “reflux”) is present in the superficial veins of the legs. This can cause pain, fatigue, itching, swelling, and varicose veins, which can lead to venous disease. Night-time symptoms include leg cramps and restless legs. Advanced disease can produce skin damage and wounds that do not heal. 

At La Jolla Vein Care, an ultrasound is used to identify the source of backwards flow in the veins and develop a personalized treatment plan. 

The best symptomatic and cosmetic results are achieved when superficial vein reflux is treated from its source, starting with the main superficial veins of the legs and leaving the skin-level (cosmetic) treatment for last. 

 

Each specific treatment plan depends on the patient’s goals. Some patients are only concerned about symptomatic improvement and avoiding complications of long term venous reflux disease. Others may be interested in cosmetic improvement. In either case, we can generally achieve an 80% improvement in symptoms and appearance of the legs. Many patients also report improvement in swelling  after venous disease treatment.  

 

Venous Disease Treatment: Saphenous Vein Reflux with a Catheter Ablation Procedure

 

The great and small saphenous travel down the inner leg and back of the leg, respectively. These veins tend to be straight and far from skin and nerves, which allows us to treat them with minimally invasive catheter procedures that are potent and precise. A catheter is a very thin tube that is inserted into the vein, similar to an IV, through which the doctor can apply heat, a rotating wire, and or medication. All modalities are about 95% effective in closing the diseased vein. None require a skin incision, so they do not leave a scar. 

 

Venous Disease Treatment: Branch Vein Reflux

 

Ultrasound-guided foam sclerotherapy is the most common treatment for branches of the saphenous veins and portions of the saphenous veins which cannot be treated with a catheter procedure (e.g. if they are too close to skin or nerves). The veins are localized with ultrasound, then the medication is given through a tiny needle. Several treatments may be needed, as we can only administer a small amount of foam per day. Large or resistant veins may require more than one injection. For very large bulging varicose veins through tiny skin incisions. This allows many veins to be treated in one day. 

 

Venous Disease Treatment: Spider Veins with Cosmetic Sclerotherapy 

 

Following treatment of the “underlying reflux” with the ultrasound-guided procedures, you may still have some prominent veins at the skin level. These can be treated with cosmetic sclerotherapy. 

 

Venous Disease Treatment: Compression of Stockings 

 

Prior to approval of treatments for vein disease, insurers require patients to try compression stockings. Medicare requires a 3-month trial of compression supervised by the treating physician. We recommend patients should wear the 20-30 mmHg thigh-high stockings for at least a day before treatment to confirm they fit. 

 

The Four Best Ways to Treat Venous Disease2022-03-17T10:25:13-07:00
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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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