21, 11, 2022

Venous Reflux Disease

2022-10-24T11:22:20-07:00

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. 

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. 

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. 

 

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. 

 

Venous Reflux Disease2022-10-24T11:22:20-07:00

28, 10, 2022

Varicose Veins: Patient Transformations

2022-09-19T20:19:29-07:00

Varicose Veins: Patient Transformations 

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. 

What causes varicose veins?

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.

La Jolla Vein Care Before and After Transformations:

 

varicose veins 50 BA VV varicose DSCF9555 fotor 1 51 BA VV varicose DSCF9625 fotor scaled 2

 

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 varicose vein treatment. 

 

“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. 

 

Varicose Veins: Patient Transformations2022-09-19T20:19:29-07:00

4, 7, 2022

Fourth of July BBQ & Venous Reflux Disease

2022-12-13T14:06:06-08:00

After a holiday, patients frequently complain about leg pain, which can be reflux venous disease. Especially holidays where hours of cooking are involved like Fourth of July, Thanksgiving, Easter, Christmas, Passover, etc. Some people who may have mild venous reflux disease, may not notice any symptoms until they are standing for hours- like during cooking. Over the years, we always hear from patients that their legs were aching and fatigued after cooking. 

The reason for this is venous reflux disease causes backflow of blood. 

The blood pools in the legs and the pooling of blood causes sensations of heaviness, fatigue, aching, and even night cramps and restlessness. Ankle swelling may also be more prominent.

Helpful tips to combat leg fatigue during the holidays: 

1.Elevating the legs allows the blood to flow in the correct direction and reduces the pooling of blood and symptoms.

2.Wearing compression stockings during cooking can be helpful to reduce symptoms. 

3.Also when standing upright for hours, it is helpful to do calf pump raises.

4.Minimize your time standing. Bring a chair to sit for the bbq or in the kitchen while you cook.

5. Delegating food preparation to other family members, to reduce standing for long periods of time, which can cause more pain.

The true culprit of leg fatigue and soreness after standing and cooking for numerous hours is leaky vein valves allowing the blood to pool, causing leg pain, heaviness, and fatigue. Try these few tips this July 4th holiday and see how you feel after. 

If you experience leg fatigue or pain after standing for long periods of time, this may be venous reflux disease, please call our office at (858)-550-0330 to schedule a consultation with one of our knowledgeable doctors at La Jolla Vein and Vascular. 

 

For more information on vein health please check out our Youtube Channel.

 

Fourth of July BBQ & Venous Reflux Disease2022-12-13T14:06:06-08:00

28, 4, 2022

Understanding Venous Disease: Venous Ulcers

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

Understanding Venous Disease: Venous Ulcers

A venous leg ulcer is the most severe form of chronic venous insufficiency.  This is referred to as a ‘venous leg ulcer.’  Venous ulcers of the leg make up 70% of all chronic leg wounds.  Therefore, a venous leg ulcer is much more common than a diabetic or arterial ulcer.  It is caused by long-standing pressure within the leg veins, resulting from 1) venous reflux through faulty valves, 2) a blockage within the deep veins or 3) from the inability to use the calf muscles or a combination.  Venous reflux is the most common cause of a venous leg ulcer.  The increased pressure within the leg veins (we call this venous hypertension) causes an inflammatory response. Inflammation then causes changes in the skin, usually around the ankles (this is where pressure is the greatest).  The inflammatory process will cause the skin around the ankles to become brown or discolored, and eventually, the skin will break open.  The leg wound can be healed by treating the underlying vein condition.  Venous ulcers on the leg can also be prevented by early intervention with non-invasive procedures.  If you have signs of chronic venous insufficiency (such as skin discoloration around the ankles) you should address your underlying vein condition to prevent the skin from breaking open.

venous ulcer

Before and after treatment of a venous ulcers.

Copyright @ La Jolla Vein Care.

venous ulcer

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

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

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

18, 3, 2022

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

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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