Dr. Fronek teaches primary care doctors to care for patients with vein problems

Dr. Fronek was recently invited to discuss vein disorders with the Family Medicine Residency Program at Scripps Chula Vista.  The doctors-in-training were excited  to learn about the variety of problems that patients have with their veins – including  spider veins,  varicose veins,  blood clots, and leg ulcers.  Primary care doctors see patients with vein disorders every day, and yet very few medical schools or residency training programs include any information about these common problems.  Dr. Fronek and Dr. Bunke-Pacquette are committed to sharing their expertise with colleagues and are frequently asked to speak at medical meetings.  Primary care doctors, in particular, can often start patients with vein disorders on conservative treatment, including graduated compression stockings and regular exercise (walking is usually the best exercise for vein disorders), as well as certain supplements such as horse chestnut seed extract, that can alleviate the symptoms that many patients with vein disease suffer from.  Informed primary care doctors can also refer patients to a vein specialist when symptoms aren’t diminished with conservative treatment, if the varicose veins worsen while a patient is using compression and exercise, or if the patient suffers from a venous leg ulcer.

Oxford University Press releases The Vein Book

The second edition of The Vein Book, edited by Dr. Nisha Bunke Paquette and Dr. John Bergan will be released on January 30th, 2014 by the Oxford University Press.

Since its initial publication nearly a decade ago, The Vein Book continues to serves as the ultimate comprehensive resource on venous disease. Upholding its reputation as the go-to reference for complete, authoritative, and up-to-date information about venous function and dysfunction, this second edition effectively bridges the gap between clinical medicine and basic science, suitable both for the seasoned surgeon as well as the medical student.

La Jolla Vein Care's Dr. Bunke releases The Vein Book

La Jolla Vein Care’s Dr. Bunke releases The Vein Book

The book is divided into five essential sections: basic considerations, primary superficial venous insufficiency, venous thromboembolism, chronic venous insufficiency, and congenital venous malformations. The book covers the entire spectrum of venous conditions from clarification of the pathophysiology of venous insufficiency, molecular mechanisms in the cause of varicose veins, new treatment options for varicose veins and spider veins, startling new treatment for venous thromboembolic disease, and effective treatment for leg ulcers.

More user-friendly and encyclopedic than ever, The Vein Book is still a must-have for vascular surgeons, phlebologists, interventional radiologists, research scientists, epidemiologists, and surgeons at all levels.  It is available for pre-order at Amazon.com.

New Varicose Vein Treatments 2014: Clarivein

CLARIVEIN Procedure to Treat Varicose Veins

The newest alternative to vein stripping surgery, and endovenous ablation procedures is Clarivein. The ClariVein procedure, also known as mechanochemical ablation (MOCA) utilizes a wire and sclerosant medication to seal shut incompetent veins. It can be performed in the office in less than an hour without using a local anesthetic.  A thin catheter is introduced into the vein under ultrasound guidance. A sclerosant medication, such as is used in sclerotherapy, is delivered via the catheter, to seal the veins shut. La Jolla Vein Care is one of the few southern California vein centers to offer the Clarivein, or mechanochemical ablation procedure. To read more about Clarivein, go to www.lajollaveincare.com.

Clarivein insertion

Clarivein insertion


Delivery of Sclerosant Solution

Delivery of Sclerosant Solution


Dr. Oz discusses DVT (blood clots in the veins)

Yesterday, the Emmy award-winning television show, Dr. Oz featured information about blood clots in the veins, specifically, deep venous thrombosis (DVT).  He demonstrated how they can break off and travel to the heart and lungs. But, what was missing from this segment was more information about what causes DVT and how can you prevent them.

What are some of the most common causes of DVT?

DVT:  There are many causes of DVT. You can categorize these into three main groups.   (Medically, these 3 risk factors for DVT are collectively called Virchow’s Triad)

A)   Decreased movement of blood (venous stasis),

  1. Decreased movement of blood can be caused by immobilization: sedentary, prolonged sitting, long plane flights or car trips, or post-surgery being inactive, and bed rest like in hospitals or nursing homes. This is where compression is crucial to preventing blood clots since the external compression increases the venous return back to the heart and reduces pooling. Venous insufficiency allows blood to pool.

B)   Increased tendency to clot (hypercoagulability)

  1. Temporary conditions such as pregnancy, cancer and obesity cause the blood to become hypercoagulable. The use of oral contraceptives, estrogens hormone replacement, testosterone, increase the risk of blood clots.
    • The likelihood of a blood clot during pregnancy is 5-20 for every 10,000 women.
    • The likelihood of a blood clot post partum is 40-65 for every 10,000 women.
  2. Genetic conditions that are inherited can increase the risk of blood clots. For example, Factor V Leiden and antiphospholipid antibody. 5% of the population carry one copy of the Factor V Leiden mutation.

C)   Damage to the blood vessel wall

  1. Trauma, injury to the leg, surgery

What can you do to prevent DVT?

Stay moving, avoid prolonged sitting. For example, when flying or traveling, the risk of DVT is 1% on a long haul flight (greater than 6 hours).  To minimize this risk, you should wear compression stockings (which helps increase the blood flow in the legs), stay hydrated, avoid excessive alcohol, use the calf muscles- walk about the cabin and frequently pump the calf muscles by doing foot lifts.

During pregnancy, compression stockings should be worn and after pregnancy, when the risk of DVT is highest (the likelihood of a blood clot post partum is 40-65 for every 10,000 women).

Your doctor can recommend to you what type of compression socks to use.  For more information about compression socks, go to compressrx.com.

La Jolla Vein Care Receives BBB Accreditation

La Jolla Vein Care is pleased to announce that it is among the handful of medical practices that is accredited by the Better Business Bureau (BBB) in San Diego.  The BBB was founded in 1912 and its accreditation means BBB has determined that the business meets accreditation standards which include a commitment to ethical practices and a pledge to continue to adhere to the BB Code of Business Practices.  The BBB Code of Business Practices is built on the BBB Standards for Trust, including eight principles that summarize important elements of creating and maintaining trust in business.

La Jolla Vein Care Featured in National Magazine

La Jolla Vein Care doctors were interviewed, then featured in three national magazines in articles about specialty health care. The national magazines include Good Housekeeping, Woman’s Day and Redbook. The article discusses the emergence of specialty health care in the field of venous disease and points out that the Doctors Fronek and Bunke-Paquette are board certified and specialize in vein disorders. There is an emphasis on specialty care and that ‘every part of you deserves knowledgeable care.’ The full articles can be found in the September 2013 Good Housekeeping, Redbook and Woman’s Day magazines on any newstand.

La Jolla Vein Care Distinguished Doctors Invited to World Congress

La Jolla Vein Care Doctors, Drs. Helane Fronek and Bunke-Paquette were Invited to participate in the Union International de Phlebology World Congress, which was held in Boston September 9th-12th. The World Congress is held every four years and includes key leaders and rule makers in the field of venous and lymphatic disorders from around the world. At the last World Congress held in Monaco in 2009, Dr. Bunke was awarded the UIP fellowship award. At this years conference, Dr. Helane Fronek was invited to speak about ‘Which Compression in Mixed, Arterial-Venous Disease’ to an audience of vascular specialists and ‘Communication Matters’ at the Nursing Symposium. She was also a guest chair and led discussions about superficial venous disease. As an expert on superficial venous disease, Dr. Bunke-Paquette was invited to be a judge of original research which was presented by very distinguished MDs and PhDs. Research topics ranged from ‘sclerotherapy for chronic venous insufficiency: a report from the american venous registry’ to ‘neovascularisation and dilated pre-formed veins at saphenofemoral junction-therapy with duplex guided foam sclerotherapy’ and ‘patient follow-up after varicose vein interventions in the UK- the view of surgeons, general practitioners and patients’ and ’12 months follow up of a randomized study comparing endovenous occlusion of the incompetent great saphenous vein with radial EVLA versus RFA ClosureFast.’

Asclera® featured on ABC’s The View

Asclera® (polidocanol) was featured on ABC’s The View last week as an effective treatment for spider veins. Asclera® (polidocanol) Injection is a prescription medicine that is used in a procedure called sclerotherapy. It is an FDA approved solution to treat spider veins and uncomplicated reticular veins.
Although Asclera® (polidocanol) has only recently made headlines on television, including being featured on The Doctors and Dr. Oz, it became FDA approved in 2010. Prior to FDA recognition as Asclera® , the generic form of the solution called polidocanol has been used for decades, especially in Europe. As a result, at La Jolla Vein Care, we have performed thousands of spider vein treatments using this medication. It is preferred over other solutions such as hypertonic saline and sodium tetradecyl sulfate because it is less painful and we find better results.
Call us today at 858-550-0330 to find out if you are a candidate for Asclera® spider vein treatment.

San Diego’s Top Doctors

La Jolla Vein Care Doctors in San Diego Magazine 2013 Top Doctors

La Jolla Vein Care Doctors in San Diego Magazine 2013 Top Doctors

Our two fantastic doctors, Dr. Nisha Bunke-Paquette and Dr. Helane Fronek were featured in San Diego Magazine’s Top Doctor Issue. They were interviewed about varicose veins, venous disease and treatment options.