27, 1, 2023

Patient Reviews and Testimonials

2023-01-14T13:09:42-08:00

La Jolla Vein & Vascular is a state-of-the-art medical center dedicated exclusively to the diagnosis and treatment of venous conditions and arterial conditions.

Venous conditions include varicose veins, spider veins, and venous leg ulcers, chronic venous insufficiency, edema, lymphedema, and deep vein thrombosis.  Arterial conditions and treatments such as peripheral arterial disease (PAD), atherectomy, angioplasty, stenting.  We also offer prostate artery embolization (PAE) to treat BPH, varicocele embolization for men and uterine fibroid embolization (UFE), pelvic venous congestion (PVCS), pelvic and labial varicose veins for women.  Osteoarthritis treatment includes genicular artery embolization (GAE) to alleviate knee pain due to arthritis.

Below are some patient reviews and testimonials. 

vein 6 1 7 1 8 1

"Bringing Experts Together for Unparalleled Venous and Vascular Care"

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled venous 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 venous 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. 

Patient Reviews and Testimonials2023-01-14T13:09:42-08:00

31, 8, 2022

Skin Darkening and Varicose Veins

2022-07-20T16:21:50-07:00

Untreated varicose veins and underlying venous insufficiency can cause changes in the skin, including skin darkening. We call this skin hyperpigmentation.  This usually occurs in the inner ankle and can worsen to involve the lower portion of the leg as shown in the picture.  Over time, the skin becomes firm, dry, eczema-like, and can even break open, causing a venous leg ulcer. When the skin becomes darker as a result of a vein problem, this is referred to as chronic venous insufficiency (CVI). This can be prevented by addressing the underlying venous insufficiency and varicose veins early on. 

 

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

How La Jolla Vein & Vascular treats patients who experience darkening of the skin:

 

Step 1: The Underlying Problem

The first step is to treat the underlying problem, the venous reflux. The specific pattern of venous reflux was detected by ultrasound. Venous reflux usually starts in the saphenous veins. The saphenous veins are most effectively treated with vein ablation procedures. This involves placing a small catheter within the vein and using heat or a solution to produce injury and eventual closure of the vein. The most commonly used treatments for the saphenous veins are radiofrequency ablation (RFA), laser ablation, mechanico-chemical ablation (MOCA or Clarivein), and in some cases Varithena Foam. The treatment Step recommendation is customized, based on where reflux is present and other clinical factors.

Step 2: Varicose Veins

After the underlying saphenous vein reflux is corrected, the bulging veins (varicose veins) can be treated by injecting a foamed medication that will cause them to scar and eventually dissolve (foam sclerotherapy), or to remove them using tiny incisions. The most common method is foam sclerotherapy. This is also known as ultrasound-guided foam sclerotherapy (UGFS).

Step 3: Spider Veins

Spider vein treatment is always considered a cosmetic procedure. If improved cosmesis is a goal of treatment, make sure to discuss this with your doctor and plan on having cosmetic treatment as the last step. Spider vein treatment is accomplished by sclerotherapy, which is an injection of a liquid medication into the spider veins. Ask your provider for an estimate about how many treatment sessions/ vials are necessary to get the results you want.

 

Skin Darkening and Varicose Veins2022-07-20T16:21:50-07:00

20, 4, 2022

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

What is a Duplex Ultrasound

2022-04-08T15:04:58-07:00

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

Before your Duplex Ultrasound test:  

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

 

Who Performs the test?

duplex

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

duplexultrasound

How long does the duplex ultrasound study take?

Approximately 45 minutes to an hour.

Is it invasive?

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

How to prepare?

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

 

What is a Duplex Ultrasound2022-04-08T15:04:58-07:00

22, 3, 2022

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

What are the adverse effects of Vein treatment?

2022-03-17T10:21:05-07:00

What are the adverse effects of Vein treatment?

Patients generally do very well with vein treatments, all of which have a low risk of complications. Some post treatment effects can include:

 

Aching over the treated veins is normal after vein treatment. This responds well to walking, ice packs, and anti-inflammatory medications such as ibuprofen (Advil, Motrin) or naproxen (Aleve). 

vein treatment pain

Bruising over injection sites is also normal after vein treatment and resolves in about two weeks. 

vein treatment bruise

Hyperpigmentation over a vein can occur from blood pigments that are released as the vein is healing. It is more common in patients with large bulging veins and certain complexions. Hyperpigmentation tends to fade over many weeks after vein treatment if you stay out of direct sunlight. 

deep vein clots

Intravascular hematoma refers to a large varicose vein that becomes firm and tender days to weeks after treatment. This also responds well to ice packs and anti-inflammatory medications. We may also recommend a confirmatory ultrasound and/or offer needle drainage of the trapped blood to alleviate discomfort and minimize skin pigmentation. 

 

Deep vein clots are very uncommon, and usually are limited to patients with poor mobility, advanced age, hormone treatment, and/or genetic tendency for clotting. We monitor all patients with ultrasound throughout treatment so we can detect clots at a very early stage before they cause a symptom. We may recommend surveillance ultrasounds, extra walking, and/or a short course of blood thinners. 

deep vein thrombosis

Numb spot over a treated vein is another uncommon event after radiofrequency or laser vein ablation. This occurs when a branch of a skin nerve gets stunned during the heat treatment. It tends to improve over several weeks. The nerves that control the movement of the leg and foot are located far from the superficial veins. 

 

What are the adverse effects of Vein treatment?2022-03-17T10:21:05-07:00

One Way To Reduce Bruising After Surgery

2022-03-17T10:10:31-07:00

One of the most common side effects after surgery is bruising. Whether it is due to plastic surgery or vein surgery, bruising and swelling are inevitable. One of the most powerful tools that we recommend for patients undergoing any type of surgery and one way to reduce bruising after surgery is RECOVA post surgery cream. 

 

Dr Nishe Bunke created RECOVA cream as a post surgical recovery cream specifically designed to reduce bruising, swelling, redness, and pain. RECOVA skin creams are packed with antioxidants and natural ingredients that promote healing and reduce inflammation. 

 

RECOVA cream aids in reducing pain, swelling, and discoloration after cosmetic surgery, injections, and procedures, laser treatments, varicose vein procedures, Sclerotherapy, minor injuries, and is one way to reduce bruising after surgery.

 

Our patients at La Jolla Vein Care have seen quick transformation post procedures. The combination of natural ingredients in RECOVA cream helps aid in quicker recovery.

 

 The powerful ingredients included in RECOVA are listed below:  

 

  • Arnica Montana is a flower extract that helps with inflammation, swelling, and bruise recovery. 

 

  • Grapeseed Oil has numerous benefits and includes numerous vitamins such as vitamin E. It is a flavonoid that aids in chronic venous insufficiency, varicose veins, and edema. 

 

  • Bromelain is an enzyme that is a natural remedy for inflammation and swelling.

 

  • Horse Chestnut is used to improve poor blood circulation, reduce swelling, and for varicose vein symptoms. 

 

  • Caprylhydroxamic Acid is an amino acid derived from coconut oil used as a gentle preservative that ensures product safety and longevity. 

 

  • Witch Hazel is used for swelling and inflammation. It is used to shrink varicose veins and hemorrhoids as well as reduce rosacea and clear redness of the skin. 

 

  • Butcher’s Broom is used for natural anti-inflammatory properties. It is used to reduce swelling and reduce varicose vein symptoms. 

 

  • Sunflower Seed Oil is packed with vitamins A, E, C, and D. 

 

  • Menthol is not present in the tinted RECOVA, since Tinted Arnica is often used around the eyes. 

 

The combination of these ingredients contributes to an overall comforting and healing sensation when applied to the skin. 

 

RECOVA is a tool that stands out due to its natural ingredients that aid in venous disease symptoms. RECOVA is hypoallergenic, and non comedogenic. RECOVA is also free of parabens, phthalates, preservatives, synthetic additives, and dyes, and never tested on animals. 

 

Patients have used RECOVA cream after vein procedures and have seen quick and lasting results. We recommend physicians offer this for patients if they complain of redness, itching, and bruising after their procedures. RECOVA offers immediate soothing relief of discomfort for our patients. 

 

Check out RECOVA online for more information and to purchase RECOVA tinted arnica cream and RECOVA post surgery cream. 

Below are a few patient transformations while using RECOVA Cream post surgical procedures.

one way to reduce bruising after surgery one way to reduce bruising after surgery

before 3 after 3one way to reduce bruising after surgery

One Way To Reduce Bruising After Surgery2022-03-17T10:10:31-07:00

28, 2, 2022

What is Venous Reflux Disease?

2022-03-17T10:21:46-07:00

What is Venous Reflux Disease?

 

Venous reflux disease is also known as venous stasis, venous insufficiency or venous incompetence and refers to ‘leaky valves’ in the veins of the legs. 

leaky valve

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 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 small saphenous vein. 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. 

leakyveinvalves

Symptoms of Venous Reflux Disease:

 

Symptoms of venous reflux disease 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 venous stasis 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. All of which are possible symptoms of venous reflux disease to look out for. 

 

What influences the development of Venous Reflux Disease?

 

A patient is more likely to develop venous reflux disease if they are:

 

  • Overweight
  • Pregnant
  • Have a family history of vein disease
  • Have damage to the leg due to injury, surgery, or previous blood clots
  • High blood pressure
  • Lack of exercise
  • Smoking
  • A blood clot in a deep vein (calf or thigh) “deep vein thrombosis” 
  • Swelling and inflammation of a vein close to the skin, known as “phlebitis”

 

How is Venous Reflux Disease Diagnosed? 

 

In addition to physical exam findings and medical history, an ultrasound examination is an important tool in the assessment of venous disease. Not all venous disease is visible to the naked eye, and it usually arises from veins that are beneath the surface of the skin, only visible by ultrasound technology. 

 

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. 

 

What is Venous Reflux Disease?2022-03-17T10:21:46-07:00
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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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