What Are Vein Valves?

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The valves inside the leg veins can be seen on ultrasound. The arrow points to a valve in the great saphenous vein within the leg.

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Leg veins have one-way valves that prevent blood from flowing backward. Diseased valves are ‘leaky’ and allow blood flow both forward and backward, eventually causing bulging of the veins, i.e., varicose veins.

In the circulatory system, the veins carry de-oxygenated blood back to the heart. The leg veins carry blood toward the heart, against gravity. Therefore, the leg veins have one-way valves the prevent back flow of blood. When the valves do not function properly, they allow blood to flow backward, causing pooling of blood. This  is referred to as venous reflux or venous insufficiency. Eventually, the backflow of the blood will cause varicose veins to develop and symptoms related to the increased pressure in the leg veins such as leg heaviness, aching, swelling, restless legs, night cramps, throbbing and pain. 

Highlights of the National Vein Congress

The La Jolla Vein Care doctors and staff attended the American College of Phlebology (ACP) Annual Conference in Phoenix last week.  More than 1,000 vein care practitioners from the United States and around the world attended the meeting to share information and research in the field of vein disorders (also known as phlebology).  The speakers included vein and vascular experts from around the world, include La Jolla Vein Care’s Dr. Fronek.  Dr. Bunke was featured in the daily congress newsletter as being the first physician to complete a specialized Fellowship program in the field of Phlebology.

La Jolla Vein Care’s medical assistants and vascular sonographers attended also to learn the most update information on a variety of vein topics including; complications in sclerotherapy, the swollen limb, thrombophilia, new anticoagulants, venous stents, compression therapy, vascular ultrasound, foam and liquid sclerotherapy, vascular malformations, lymphedema, venous system during pregnancy, venous skin changes, dvt and superficial thrombophlebitis, chronic venous insufficiency and research on specific vascular topics.

 

 

 

Dr. Fronek to Speak at ACP Annual Congress in Phoenix

Dr. Fronek

Dr. Helane Fronek to speak at the ACP Annual Congress in Phoenix.

La Jolla Vein Care’s Dr. Helane Fronek was invited to speak to her peers at the upcoming, American College of Phlebology (ACP) Annual Congress in Phoenix.  This congress is the country’s largest peer-education forum dedicated to the diagnosis and treatment of venous and lymphatic disease. Attended by hundreds of vein care specialists, from physicians to nurses to researchers, the Annual Congress is one of the best opportunities to learn directly from experts in the field and connect with other medical professionals in the field of vein care. Each year, approximately 900 vein care specialists from across the globe come together at our Annual Congress. Participants come from all areas of the medical profession–physicians, nurse practitioners, ultrasound technologists, and researchers attend the Annual Congress to discuss the latest technology, treatments and advances from  experts in the field of venous and lymphatic disease.

Dr. Fronek is a past president of the ACP and an active member. She will be speaking about various topics on venous disease.

La Jolla Vein Care Amongst San Diego’s Top Doctors

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La Jolla Vein Care doctors featured in San Diego Magazine’s Top Doctors Issue 2014.

La Jolla Vein Care doctors Nisha Bunke, M.D. and Helane Fronek, M.D. were featured in the October issue of San Diego Magazine’s  Top Doctors issue 2014 for vein specialists. Pick up a copy of San Diego Magazine to read their article. Congratulations to our friend and colleague, Dr.  Kulreet Chaudhary who graced the cover of the Top Doctors issue.

Muscle Hernia or Varicose Veins?

Muscle herniations of the legs frequently are confused with varicose veins. Patients may present with bulging along the outer part of the shin, that looks like a varicose vein. It may or may not be painful. It goes away with flexing the foot (pointing your toes to your head).  But, to experienced vein care specialists, it is clearly a muscle herniation.

A Muscle herniation is a focal protrusion of muscle tissue through a defect in the deep fascial layer. Anterior tibial muscle is the most commonly affected muscle of the lower extremities because its fascia is the most vulnerable to trauma. Clinically it is characterized by asymptomatic or painful, skin-coloured, soft, subcutaneous nodules of various size depending on the position. The diagnosis is usually made clinically based on its typical manifestations, but ultrasonographic examination is useful for detecting the fascial defect and excluding other conditions caused by soft tissue tumours such as lipomas, angiolipomas, fibromas, schwannomas or varicosities.

Usually, surgical treatment is not needed, but may be necessary for increasingly painful hernias.

At La Jolla Vein Care, we frequently see muscle herniations that are confused with varicose veins. Using ultrasound technology and a clinical examination, we can make the accurate diagnosis.

World Thrombosis Day

Venous thrombosis is an extremely important condition, that we take very seriously at La Jolla Vein Care. Since we deal with veins, we frequently diagnose this condition  in our office.  This condition always requires attentions, as consequences can be severe and life-threatening in some cases.  The following about World Thrombosis Day, which is a movement to increase public and professional education about blood clots,  is reprinted from worldthrombosis.org.

World Thrombosis Day (WTD) is one day – October 13 – around the world dedicated to focusing attention on the often overlooked and misunderstood disease burden caused by  thrombosis globally…but it is not a one-time observance.

Thrombosis refers to a blood clot that forms in your artery or vein. It is the one disorder that causes the world’s top three cardiovascular killers: heart attack, stroke and venous thromboembolism (VTE) – a blood clot mostly in the leg or lungs. While most people are aware of heart attack and stroke, fewer people know about VTE. That’s why VTE is our initial focus for WTD. 

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La Jolla Vein Care supports World Thrombosis Day

The World Health Assembly has set a global target of reducing premature deaths from non-infectious disease, including cardiovascular disease, by 25 percent by 2025. To meet this goal, we must reduce thrombosis.

 

Inherited Risk of Deep Venous Thrombosis (DVT)

The Factor V Leiden mutation is one of the most common inherited genetic mutations, causing blood clotting disorders. It is found in 4% to 6% of the U.S. population.

If someone has one copy of this genetic mutation (heterozygous), they are considered a carrier of the mutation.  A carrier has an approximate 3 to 6 fold increased risk of venous thromboembolism.  If a person carries two copies of the genetic mutation (homozygous) their risk of a blood clot is much higher, and many of these patients will be on lifelong blood thinners. This risk is increased when exposed to other risk factors such as pregnancy, oral contraceptives, immobility, and surgery.  If you are Factor V Leiden, the doctor may recommend a blood thinner during varicose vein treatment. It is important to talk with your doctor about your history or family history of blood clotting disorders, to better reduce your risk of a blood clot when undergoing any type of procedure or surgery.

 

Varicose Veins and Heart Disease

Are varicose veins associated with heart problems?

Varicose veins are not associated with heart disease and do not indicate a problem with the heart.  With varicose veins and venous insufficiency, the vein valves are weak and leaky. But, only the valves in the leg veins are affected. These valves are different than heart valves.  Additionally, heart disease healthy_and_diseased_valvesoften refers to problems with the arteries of the heart or the heart muscle itself, not veins. In sum, if you have varicose veins, it does not mean that you are more likely to have problems with the heart.

Importance of a Certified Sonographer

October is ultrasound awareness month.  The goal of ultrasound awareness month is to educate the public about the role of medical ultrasound in healthcare.  At La Jolla Vein Care, ultrasound is essential to confirm the diagnosis of many vein disorders, such as venous insufficiency, venous reflux disease, and deep venous thrombosis.  Fortunately, we have three ultrasound scanning machines on-site at our facility. We also have two certified, vascular technologists (also referred to as vascular sonographers) who perform the ultrasound studies.  Our vascular technologists have specialized training in vascular ultrasound, also known as vascular sonography.
The designation RVT, stands for registered vascular technologist.  This designation means that they have demonstrated quality care,  Nikki  patient safety and continuing competency of ultrasound professionals. They have passes a series of rigorous examinations to earn the certification, and as a result, our patients are receiving the highest level of care.
Different terms of Sonography
Sonography – using the reflections of high-frequency sound waves (ultrasound) to construct an image (a sonogram) of a body organ or vascular structures like veins.
Ultrasound – the use of ultrasonic waves for diagnostic or therapeutic purposes, specifically to image an internal body structure, monitor a developing fetus, or generate localized deep heat to the tissues.
Transducer – a device that receives a signal in the form of one type of energy and converts it to a signal in another form
Sound wave – a wave that transmits sound.
Sonographer – a specialist in the use of Sonography; a person who performs the sonographic exam (ultrasound).

Blood Clotting Mutation Affects 1-2% of the Population

A point mutation (G20210A) in the Factor II (prothrombin) gene is the second most common cause of inherited blood clots and accounts for 20% of the inherited blood clotting disorders. The incidence of this mutation in the Caucasian population is 1-2% and in African Americans it is 0.1%. Carriers of this mutation have an increased risk (3x) of developing a blood clot in the deep veins (deep venous thrombosis or DVT).  A test for this mutation is usually only recommended if there is a family history of blood clots (DVT) or in cases where the cause of the blood clot is not clear or in pregnant women with recurrent miscarriages.  A more common cause of a blood clotting disorder that is inherited from the parents is the Factor V Leiden mutation.