31, 5, 2020

Approach to Vein Treatment

2020-09-18T18:51:19-07:00

Venous Reflux Disease is Treated By a Staged Approach

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 withinpage2image34774576

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 Veinsvaricose vein valve image on legs

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.

photo of spider veins

close up photo of spider veins

page2image66292544

Approach to Vein Treatment2020-09-18T18:51:19-07:00

Best Exercises for Varicose Veins

2020-09-18T18:53:02-07:00

Physical activity provides a wide range of benefits for vascular health and may help to avoid evolution of mild cases of varicose veins. In fact, exercise is considered to be a fundamental element in improving the symptomatology of patients affected by varicose veins. A sedentary person diagnosed with this medical condition has a much higher risk of worsening the symptoms when compared with an active person with the same condition. This is a result of blood pooling in the veins, causing an increase in venous hypertension and symptoms.

The main goal of exercise in regards to varicose veins is to contract and move the muscles of the leg, helping to pump the blood upwards, avoiding edema or retention of liquid in the ankles. With this in mind, the recommended exercises are those with aerobic characteristics rather than those with anaerobic ones. Through this physical activity, the pressure in the veins is improved, as well as the resulting symptomatology.

Therefore, any exercise that involves moving the lower limbs and promote cyclical muscle contractions is advisable, including stand on tiptoes, move the toes, perform foot bending and rotation, do pedaling movements, among others. These can be easily performed throughout the day without the necessity to go out and exercise, and are especially useful during work hours or while doing daily tasks at home.

When walking or running, pressure is exerted on the sole of the foot, which causes the circulation to be activated from the bottom up, while the constant contraction of the muscles during cycling causes the same effect, but without the presence of high impact, an important factor for those with joint issues.

Swimming is one of the best exercises to practice when affected by varicose veins. The double effect of the water and the movement of the lower limbs cause an incredible increase in blood circulation. This is helpful also for patients who have significant symptoms related to the effects of gravity, like standing.

Other disciplines like yoga, pilates, or rhythmic gymnastics also help stimulate circulation by mobilizing the accumulated blood in the thighs, while relaxing the whole body.

Hiking is a great activity for using the calf-muscle pump. However, in warm weather, symptoms of varicose veins worsen. To get the maximal benefit of exercise and reducing symptoms, outdoor exercising when the weather is cooler, like in the morning is advised.

Best Exercises for Varicose Veins2020-09-18T18:53:02-07:00

Micro-Phlebectomy to Remove Varicose Veins

2021-12-30T11:47:53-08:00
Micro-Phlebectomy involves using a scalpel to make tiny incisions (less than 3mm- about the size of a grain of rice) along the legs to remove the veins. This is performed with local anesthesia that is used to numb the skin of the leg. This procedure may take 1 to 2 hours, depending on the extent of the individual’s varicose veins. Return to normal activities after the procedure is possible. There will be significant bruising with this procedure. The benefit is that the veins are removed immediately, although it may take several weeks for the bruising to resolve. This procedure may be performed in conjunction with other procedures or stand-alone, depending on the individual’s specific vein issue. Alternatives to Micro-phlebectomy are foam sclerotherapy, which is an injection into varicose veins to cause them to shrink and eventually disappear. Discuss with your doctor which treatment is better for you.

Preparing for your Procedure:

There are no medication restrictions before the procedure. If you have asthma, please bring your inhaler with you to your appointment, or your doctor may have recommended taking an antihistamine such as Claritin prior to the procedure. You should take this the morning of your treatment.

Please notify our office if you are scheduled to have any type of medical procedure or surgery 2 weeks prior to or after your treatment.

If you choose to take the light sedative offered, be sure to make arrangements for transportation to and from the procedure, as you will not be able to drive yourself home. The morning of your procedure, please shower and thoroughly wash your leg with soap from your groin to your ankle and wear loose-fitting pants to your appointment. It is also advised for you to bring an extra pair of underwear with you to your appointment. It would be best if you have a light meal before you arrive. You may bring a book or an iPod to listen to during the procedure. We also offer a movie to watch during the procedure. If you already have 30-40 thigh-high compression stockings, please bring them with you to your appointment. If not, we will fit you for stockings on the day of your procedure.

 

Micro-Phlebectomy to Remove Varicose Veins2021-12-30T11:47:53-08:00

How to Manage Varicose Vein Pain at Home

2021-11-03T16:37:58-07:00

While venous interventions are the best way to alleviate long-term pain related to varicose veins, symptoms can be managed conservatively at home. Especially under the stay-at-home safe harbor orders.  Conservative management can be helpful to relieve symptoms and also prevent complications (such as thrombophlebitis). These include:

  • Avoid standing or sitting for long periods of time:  To keep blood moving when you have to sit or stand for long periods, try these tips: at work, take walking breaks and try walking during your lunch hour. While sitting, try flexing your feet up and down 10 times an hour. When standing, raise yourself up and down on your toes or rock back and forth on your heels.

Varicose Vein Pain, Walking Breaks At Work

  • Exercise: Exercising is good for your veins because it improves blood flow. Walking, cycling or swimming are great exercises for vein health. But be sure to check with your doctor before starting any exercise program.

exercises for vein health

  • Weight loss or maintaining a healthy weight: Being overweight puts extra pressure on your veins.

Manage Varicose Vein Pain Method, Weight Loss or Maintaining A Healthy Weight

  • Leg elevation: Use leg elevation three or four times a day for about 15 minutes at a time. Even elevating your legs on a step stool or ottoman is beneficial. If you need to sit or stand for a long period of time, flexing (bending) your legs occasionally can help keep blood circulating. If you have mild to moderate varicose veins, elevating your legs can help reduce leg swelling and relieve other symptoms.

Manage Varicose Vein Pain Method, Leg Elevation

  • Compression stockings: These elastic stockings squeeze or compress the veins and prevent blood from flowing backward. Compression stockings must be graduated, medical-grade compression to be beneficial. TED hose are not adequate to reduce symptoms in venous disease for active patients. Although we typically recommend being fit for compression stockings, compression stockings can be purchased at home, from online resources. Email us if you would like suggestions.

Manage Varicose Vein Method Compression Stockings

  • Supplements such as horse chestnut and grape seed extract can help reduce symptoms of venous disease. Vascular is a prescription medication that may be helpful for some. Always check with your PCP before starting supplements or new medications as there may be side effects.
  • A flavinoid-rich diet including berries, green teas can reduce inflammation and pain.
  • Anti-inflammatory medications such as ibuprofen
  • ice packs are my favorite way of reducing painful veins. Put ice cubes in a ziplock bag and apply to tender veins.
  • Anti-inflammatory creams can be prescribed to apply directly to painful veins.
How to Manage Varicose Vein Pain at Home2021-11-03T16:37:58-07:00

Vein Treatment During COVID-19

2020-09-18T18:57:42-07:00

The International Union of Phlebology (UIP) Published a Consensus Document in the Journal of Vascular Surgery regarding the treatment of patients with vein disorders during COVID: Triage of Patients with Venous and Lymphatic Diseases during the COVID-19 pandemic- the Venous and Lymphatic Triage and Acuity Scale (VELTAS). 

We are pleased to report that our own practice guidelines are entirely consistent with the recent UIP recommendations; and we are excelling at allowing urgent as well as semi-urgent (patients who are highly symptomatic) to be seen typically within one week.

The purpose of the triage scale developed by International Union of Phlebology (UIP) is to ensure that patients with venous and lymphatic disorders receive care in a timely fashion without compromising healthcare resources needed for the pandemic and without imposing undue risks to patients and health care providers.

Triage urgency was categorised into four groups and individual conditions were allocated to each class of triage. These included 1) Medical Emergencies (requiring immediate attendance), example massive pulmonary embolism; 2) Urgent (to be seen as soon as possible), example deep vein thrombosis ; 3) Semi-urgent (to be attended to within 30-90 days), example highly symptomatic CVD, and 4) Discretionary/Non-urgent- (to be seen within 6-12 months).

La Jolla Vein Care’s statement is as follows:

‘While we continue to encourage virtual visits and at-home mobile ultrasound diagnostics, our office has re-opened for medical necessity treatments and for those who require in-office visits. Medical necessity conditions include complications from venous reflux disease and varicose veins such as thrombophlebitis (blood clots), vein hemorrhages, venous leg ulcerations (open leg wounds), and symptoms that interfere with one’s ability to work or maintain daily activities such as leg pain, heaviness, throbbing, swelling and night symptoms that interfere with rest such as restlessness and night cramps.’ Cosmetic spider vein treatments are postponed until a future date.

This means that patients who suffer from symptoms of varicose veins and CVI, and those with complications do not have to put off their vein care. We continue to be committed on a daily basis to helping our patients. If you have a vein condition you would like to have addressed, please call us at 858-550-0330.

 

Vein Treatment During COVID-192020-09-18T18:57:42-07:00

Memorial Day Observation

2020-09-18T18:59:22-07:00

In observance of Memorial Day, our office is closed. We would like to honor the men and women who have sacrificed their lives while serving in the military. Most of us at La Jolla Vein Care have a direct military connection, and we continue to honor veterans and current military. We have chosen to be a vein care provider for veterans, military retirees, and active military and their spouses with VA CHAMPS, and Tricare.

Both Dr. Bunke and Dr. Lucas have cared for veterans at the VA HealthCare San Diego and VA Memphis correspondingly.

Memorial Day Observation2020-09-18T18:59:22-07:00

How to Treat Leg Spider Veins

2020-09-18T19:01:10-07:00

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 modern solutions such as Asclera, allow for spider veins to be treated with minimal discomfort and immediate return to activities. Saline solutions are rarely used these days by vein specialists, because alternatives solutions are less painful and better tolerated. Sclerotherapy is the preferred  over laser in most cases of spider veins on the legs, because spider veins often have underlying ‘feeder veins’ that can easily be treated with sclerotherapy, but are not addressed by laser. Laser may be used for the fine thread like veins, most common on the face. Many people will require more than one treatment session for optimal results. The national average is 2 to 5 treatment sessions. Wearing compression stockings after treatment will improve results.

 

How to Treat Leg Spider Veins2020-09-18T19:01:10-07:00

Nutritional tips for varicose veins

2020-09-18T19:02:32-07:00

Varicose veins are bulging, purplish-colored veins that occur when the one-way valves, which are responsible for regulating the constant flow of blood, become weak, especially in the lower limbs. Although many consider them a simple aesthetic problem, they can be a sign of circulation disorders, fluid retention, and inflammatory diseases. Fortunately, this condition can be significantly improved by making better nutritional choices before it becomes chronic.

In a diet to prevent varicose veins, it is suggested to increase the intake of some foods that promote blood flow. Similarly, the aim is to control total calorie consumption, since lowering the body mass index is a determining factor both in avoiding varicose veins and in reducing them.

Another objective is to help control the body’s inflammatory processes, whose alteration may trigger this condition. Additionally, this allows decreasing the pressure on the legs, which controls symptoms, such as heaviness and pain. So, what you need to do nutritionally speaking?

Increase Omega-3 consumption. Due to their ability to cleanse the arteries, these fatty acids are ideal for reactivating circulation, lowering cholesterol, and preventing possible blockages. These healthy fats control excess inflammation and help maintain good cardiovascular health. Choose oily fish, nuts, and seeds.

Eat more fiber. Fiber-rich foods are allies in lowering cholesterol levels and optimizing circulation. They also reduce constipation so that there are no difficulties due to the pressure produced by the difficulties in defecating. Choose fruits, vegetables, whole grains, legumes, nuts, and seeds.

Consume more folic acid. Foods containing folic acid help reduce homocysteine, an element that causes injury to the artery walls. They also prevent the appearance of thrombi, a chronic disorder that affects varicose veins and cardiovascular disease. Choose spinach, asparagus, cabbage, beef liver, whole grains, and nuts.

Increase the dose of vitamin E. This well-known antioxidant is essential in preventing varicose veins because it promotes the breakdown of lipids in the blood and optimizes circulation. Choose fruits, avocado, and olive oil.

Include diuretic ingredients. These can stimulate the elimination of retained fluids to decrease the overload of the legs. Therefore, their inclusion in the diet promotes the relief of varicose veins and prevents other diseases associated with poor circulation. Choose pineapple, artichoke, lemon, cucumber, blueberries, and parsley.

Limit salt consumption. Maintaining a sodium-rich diet is one of the factors that increase the risk of varicose veins, producing edema and high blood pressure. Because of this, it is essential to limit its intake and seek healthy alternatives. Choose healthy spices like oregano, thyme, garlic, and turmeric.

Consume healthier drinks. Healthy drinks complement the effects of the diet to prevent varicose veins. Adequate fluid assimilation helps balance inflammatory processes and promotes proper blood flow by regulating fluids in the tissues. Choose plain water and healthy smoothies or juices.

Nutritional tips for varicose veins2020-09-18T19:02:32-07:00

Leaky Vein Valve Disease and Varicose Veins

2021-11-05T10:56:55-07:00

Venous reflux disease 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 of 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 the small saphenous vein, which courses up the back of the calf. 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 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.

Leaky Vein Valve Disease and Varicose Veins

Leaky Vein Valve Disease and Varicose Veins2021-11-05T10:56:55-07:00

Venous Reflux is a Progressive Condition, Worsens Over Time

2021-12-31T14:18:52-08:00

6 Chronic Venous Insufficiency Stages

Venous reflux disease is also known as venous stasis, venous insufficiency, or venous incompetence. Venous reflux disease refers to “leaky valves” in the veins of the legs. Venous 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 of 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 the small saphenous vein, which courses up the back of the calf. 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 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.

Stage 1. Healthy Veins, Stage 2. Spider Veins

Stage 1. Healthy Veins, Stage 2. Spider Veins

Stage 3. reticular veins and varicose veins

Stage 3. reticular veins and varicose veins

Stage 4. Venous Nodes - Edema venous insufficiency

Stage 4. Venous Nodes - Edema venous insufficiency

Stage 5. Chronic insufficiency

Stage 5. Chronic insufficiency

Stage 6. Venous eczema and venous leg ulcer

Stage 6. Venous eczema and venous leg ulcer

Venous Reflux is a Progressive Condition, Worsens Over Time2021-12-31T14:18:52-08:00
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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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