14, 3, 2022

How is Venous Reflux Disease Treated?

2022-03-17T10:19:57-07:00

How is Venous Reflux Disease Treated? 

 

Step 1: Identifying the underlying problem

The first step is to treat the underlying problem, venous reflux disease. The specific pattern of venous reflux disease 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 eventful 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 recommendation is customized, based on where reflux is present and other clinical factors.  

radiofreqgraphic

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). Both these treatments can treat venous reflux disease. 

 

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 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. 

 

How is Venous Reflux Disease Treated?2022-03-17T10:19:57-07:00

Why Was I Offered a Phlebectomy?

2022-03-17T10:19:18-07:00

Micro-Phlebectomy for varicose veins 

 

A phlebectomy 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. 

microphlebectomy

What are the options for treating bulging varicose 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 a 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. 

How does the procedure work?

The skin is numbed with lidocaine, then a tiny puncture is made in the skin (about ½ 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. 

 

What should I expect on the day of treatment? 

The procedure 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. We will mark your bulging veins with a marker. A small hook will be used to bring the veins to the surface. More numbing medication will be infused around the veins. You will feel pressure as the veins are removed but not pain. Usually about 10-12 veins are removed.

Once the procedure is done, we will apply skin glue to the tiny puncture sites, then sterile bandages. We will help you into your compression stocking and place an ACE wrap around the treated area. You will walk for 30 minutes prior to getting in your car. The ACE wrap can be removed that night or the next day. You will wear the compression stocking for 72 hours continuously. 

 

Why Was I Offered a Phlebectomy?2022-03-17T10:19:18-07:00

The Best Way to Treat Reticular Veins

2022-03-17T10:17:12-07:00

The best treatment for Reticular Veins is through a painless alternative to traditional sclerotherapy: Cryo-Sclerotherapy.

Why have I been offered cryo-sclerotherapy?

 

We recommend patients undergo cry-sclerotherapy to mainly treat spider veins and small varicose veins at the skin surface (also known as reticular veins). Traditional sclerotherapy involves injection of a medication into the vein using a tiny needle. This causes the vein to collapse and eventually fade away. The medication will be administered in a liquid and /or foam formulation, depending on the size of the veins. Cryo-sclerotherapy is the combination of traditional sclerotherapy in combination with the use of a cryo device. The cryo device delivers puffs of cold air simultaneously during sclerotherapy. The result  is the cold air anesthetizes the skin so the treatment is relatively painless. This is especially helpful for treatment of sensitive areas like the inner ankles and thighs. Instead of feeling the needle prick, you will feel puffs of cold air instead. The cold air may also reduce bruising and pain. 

 

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. The sclerosant medication will then be injected into your veins with a fine needle. Just before the needle is used, you will feel puffs of cold air. The cold air will anesthetize the skin, so that the prick from the needle is not felt or lessened. Every time the needle is used, you will feel puffs of cold air instead. After your treatment, we will help you into your compression stockings, then you will walk for 30 minutes prior to getting in your car. It is normal for your legs to be achy and tender to the touch after treatment. 

 

What should I do after treatment?

 

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. 

 

You may shower with the stockings on or take a quick cool shower with them off. 

 

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. 

 

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 should I avoid after 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. 

 

What are the possible side effects? 

 

You will likely have some bruising over the injection sites, then the treated veins may become firm and blue. 

 

The skin overlying 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. Some patients temporarily develop some very fine, pink spider veins in areas where veins have been treated (telangiectatic matting). These usually resolve spontaneously over several weeks but occasionally require additional treatment to clear. 

 

Many patients will feel their veins look a bit worse in the first month after sclerotherapy, but through the best treatment for reticular veins, cryo-sclerotherapy, patients have reported it to be a more painless approach for treatment.  

 

The Best Way to Treat Reticular Veins2022-03-17T10:17:12-07:00

The Best Way to Treat Spider Veins

2022-03-17T10:12:50-07:00

The best way to treat spider veins is through a procedure called Sclerotherapy. At La Jolla Vein Care we have seen great patient transformations with this type of therapy. If you are interested in knowing if you have spider veins, check this article out. 

 

Sclerotherapy

Why was I recommended to have sclerotherapy injections?

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 newer solutions such as Asclera allow for spider veins to be treated with minimal discomfort and immediate return to activities.

Vein specialists rarely use saline solutions these days, because alternative solutions are less painful and better tolerated. Sclerotherapy is preferred by most vein specialists over laser because spider veins often have underlying feeder veins that can easily be treated with sclerotherapy, but are not addressed by laser. Many people will require more than one treatment session for optimal results. The national average is 2 to 5 treatment sessions. Treatment sessions are often spaced a month apart, but your health care provider will help determine your customized care plan. Wearing compression stockings after treatment will improve results. 

 

For larger veins, the medication may be turned into a foam, this is referred to as foam sclerotherapy. Foam sclerotherapy is similar to sclerotherapy of spider veins but instead of a liquid solution, a foamed-solution is injected directly into the vein via a small needle. The solution can be seen on ultrasound monitoring which allows it to be directed into nearby varicose veins painlessly. The veins will seal shut, and gradually be broken down by the body. 

 

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. The sclerosant medication will then be injected into your veins with a fine needle. After your treatment, we will help you into your compression stockings, then you will walk for 30 minutes prior to getting into your car. It is normal for your legs to be achy and tender to the touch after treatment. 

 

What should I do after treatment? 

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. You may shower with the stockings on or take a quick cool shower with them off. 

 

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. 

 

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 should I avoid after 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. 

 

What are the possible side effects?

You will likely have some bruising over the injection sites, then the treated veins may become firm and blue. 

 

The skin overlying 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. Some patients temporarily develop some very fine, pink spider veins in areas where veins have been treated (telangiectatic matting). These usually resolve spontaneously over several weeks but occasionally require additional treatment to clear. If you notice the spider veins have not gone away after treatment, this information may be helpful for you. 

Below are the before and after transformations that we have seen in patient cases with spider veins and sclerotherapy.

1 the best way to treat spider veins  4

The Best Way to Treat Spider Veins2022-03-17T10:12:50-07:00

The Best Treatment for Saphenous Vein Reflux

2022-03-17T10:11:22-07:00

The best treatment for Saphenous Vein Reflux is tailored to the individual 

 

Fortunately, there are a variety of non-surgical treatment options for saphenous vein reflux, the underlying cause for varicose veins and it’s symptoms. Because vein treatment is not, ‘one treatment fits all,’ the treatment plan should be customized to the patient. Non-surgical options include, laser vein ablation, radiofrequency vein ablation, varithena foam, venaseal an mechanical-chemical ablation, also known as clarivein. This article will specifically discuss features about Clarivein which make it a good option for some patients.

Mechanical-Chemical Ablation (Clarivein) for Saphenous Vein Reflux 

The ClariVein procedure for treatment of backwards flow (or reflux) in your saphenous veins. 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. This minimally invasive procedure can be performed in the office in less than an hour. This offers patients the benefit of being able to 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. 

 

This technique is highly effective in closing the vein and only requires one skin puncture, similar to placing an iv. 

 

What should I expect on the day of treatment? 

The procedure 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. The patient will change into a gown and leave underwear on. Depending on the vein to be treated, the patient will lay on the back or on the belly. We do our best to make special accommodations (for example, if the patient cannot lie flat or cannot bend a knee very well) with body positioning and using pillows. We will do our best to make the patient comfortable. Then, we will give the option of watching a movie on Netflix or listen to music. Once the patient is comfortable, the leg will be prepped with a cleansing solution for the sterile procedure. The doctor will perform an ultrasound to map the vein 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 ClariVein catheter. Once the catheter and rotating wire are in place, the doctor will start the treatment. It is common to feel a tickling or vibrating sensation as the doctor treats the vein. Patients usually have minimal to no pain during this procedure. Once the vein has been treated, the patient will wear compression stockings for 72 hours continuously. The benefits of wearing compression stockings during post surgical recovery are mentioned here

 

What should I do after 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 will alleviate discomfort and avoid pooling of blood in the legs. 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). Compression stockings are recommended for after treatment. 

 

What should I avoid after 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. 

 

What are the possible adverse effects? 

Expect some bruising over the puncture site, which fades over about two weeks. The skin overlying larger varicose veins may also develop some temporary inflammation and/or brownish hyperpigmentation as the blood products within those veins are absorbed by the body. An uncommon complication is a blood clot within a deep vein. 

Videos of the treatment, as well as after care instructions can be found on our website or our Youtube Channel.

The Best Treatment for Saphenous Vein Reflux2022-03-17T10:11:22-07:00

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

9, 2, 2022

How to Earn Vein Center Accreditation by IAC in 2022

2022-02-11T17:53:26-08:00

How to earn vein center accreditation by IAC in 2022

More than one half of Americans age 50 and older are affected by varicose veins. Varicose veins occur when the valves in the leg veins no longer function, causing blood to pool in the legs. In some cases, this condition progresses to a more serious form of venous disease called chronic venous insufficiency (CVI). Whether to relieve symptoms and/or improve appearance, treating varicose veins can be performed by vein centers that specialize in the evaluation and management of superficial venous disorders. Through vein center accreditation, one can feel confident in choosing the best providers and treatments for their vein disease.

There are many factors that contribute to an accurate vein treatment and management. The training and experience of the vein specialist performing the procedure, the type of equipment used and the quality assessment metrics each facility is required to measure, all contribute to a positive patient outcome. IAC accreditation is a “seal of approval” that patients can rely on as an indicator of consistent quality care and a dedication to continuous improvement.

La Jolla Vein Care located in La Jolla, CA has been granted vein center accreditation by the Intersocietal Accreditation Commission (IAC) in the area of Superficial Venous Treatment and Management.

This latest accreditation awarded to La Jolla Vein Care demonstrates the facility’s ongoing commitment to providing quality patient care in vein treatment and management.

How to earn vein center accreditation:

Accreditation by the IAC indicates that La Jolla Vein Care has undergone an intensive application and review process and is found to be in compliance with the published Standards, thus demonstrating a commitment to quality patient care in vein treatment and management.

  • A detailed self-evaluation
  • Followed by a thorough review by a panel of medical experts

The IAC accreditation process enables both the critical operational and technical components of the applicant facility to be assessed, including representative case studies and their corresponding final reports.

About IAC

IAC provides accreditation programs for vascular testing, echocardiography, nuclear/PET, MRI, diagnostic CT, dental CT, carotid stenting, vein treatment and management and cardiac electrophysiology.

The IAC programs for accreditation are dedicated to ensuring quality patient care and promoting health care and all support one common mission:

Improving health care through accreditation®. IAC accreditation is widely respected within the medical community, as illustrated by the support of the national medical societies related to venous disorders, which include physicians, physician extenders, nurses and ultrasound technologists. To date, the IAC accrediting divisions have granted accreditation to more than 14,000 sites throughout the United States, Canada and Puerto Rico.

How to Earn Vein Center Accreditation by IAC in 20222022-02-11T17:53:26-08:00

21, 1, 2022

AVANTA IPA is the Newest Insurance Accepted for Vein Care

2022-01-21T12:03:53-08:00

AVANTA LOGO

Avanta IPA


We are pleased to announce that we accept AVANTA IPA healthcare insurance at La Jolla Vein Care. Now offering vein care services including evaluation and treatment of varicose veins, venous reflux disease, leg swelling, chronic venous insufficiency, deep venous thrombosis (DVT) and ultrasound imaging for DVT and other vascular conditions,
AVANTA IPA San Diego, La Jolla, Carmel Valley, Chula Vista, San Marcos, Vista, Escondido, La Mesa.

We accept several other insurance types, click here to read our full list of insurances accepted by La Jolla Vein Care.

AVANTA IPA is the Newest Insurance Accepted for Vein Care2022-01-21T12:03:53-08:00

17, 3, 2021

Dr. Foghi in the News

2021-04-11T02:59:20-07:00
SDMETRO BLUE LOGO e1615442249242

 

Daily Business Report

Dr.Foghi

Vein specialist Dr. Armin Foghi joins La Jolla Vein Care

La Jolla Vein Care (LJVC) announced the hire of Dr. Armin Foghi, M.D., vein specialist and recognized invasive/non-invasive cardiologist. With approximately 50 percent of the population suffering from some sort of heart or blood vessel disease, this latest addition to LJVC’s team is designed to both accommodate growing demand and add an additional complementary layer of medical specialization to the practice.

With more than 15 years of experience in advanced circulatory system treatment, Foghi’s career trajectory has included prominent roles such as assistant professor at the University of New Mexico School of Medicine, chief of cardiology at Eastern New Mexico Medical Center and founder and medical director of cardiology at the Myo Vein Clinic. During his tenure at Myo, the organization was recognized nationally as the Center of Excellence for complete and comprehensive vein treatment and served as a training center for physicians across the U.S.

Foghi has also served as the medical adviser for the New Mexico Athletic Commission, where he worked directly with professional athletes participating in competitive combat sports. With a passion for service to others through education, he is also an active cardiovascular disease educator and lecturer and has served in various residency training and clinical professor at physician assistant programs.

Dr. Foghi in the News2021-04-11T02:59:20-07:00

1, 7, 2020

La Jolla Vein Care Joins Health Excel IPA

2020-09-17T17:41:53-07:00

La Jolla Vein Care has joined Health Excel IPA and will be contracted with some new insurances beginning today, July 1st. This is exciting news and means that more people will have access to our vein care services including ultrasound diagnostics, leading edge vein treatments,expert physicians, and concierge-style practice, and customer service.  The contracted plans with Health Excel IPA are below:

Blue Shield HMO

Golden State

Alignment

Imperial Health

Brand New Day

According to Health Excels website: ‘San Diego County-based independent physician associations (IPAs) have joined forces to create a new administrative organization with the goal of providing enhanced healthcare services to patients and payers. The new entity, called Health Excel, counts more than 1200 Healthcare Providers as members — over 300 Primary Care Physicians, and over 700 Specialists — making it one of the largest independent organizations in San Diego County. Virtually every medical specialty will be represented by Health Excel doctors.’ To read more about Health Excel, click here to go to their website.

La Jolla Vein Care Joins Health Excel IPA2020-09-17T17:41:53-07:00
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