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Blood Vessel Diseases that can be Diagnosed with Duplex Ultrasound

Duplex ultrasound combines Doppler flow information and conventional imaging information, sometimes called B-mode, to allow physicians to see the structure of your blood vessels. Duplex ultrasound uses sound waves to get images of your blood vessels. It also helps determine how fast blood moves through the vessels. It can also be useful to estimate the diameter of a blood vessel as well as the amount of obstruction, if any, in the blood vessel. Using duplex ultrasound technology, the structure of your blood vessels, the valve function, the movement of your red blood cells and direction of blood flow through the vessels, and any blockages or blood clots can be seen.

Diseases of the blood vessels can affect both veins and arteries.

Vascular refers to the blood vessels in the body. There are two main types of blood vessels; the arteries and veins. Arteries bring oxygen-rich blood from the heart to every inch of the body; vein return the blood back to the heart and lungs for more oxygen. Vascular disease is when the blood vessels are no longer healthy.

Common types of vein disease include:

  • Varicose veins
  • Chronic venous insufficiency
  • Deep venous thrombosis

Common types of artery disease includes:

  • Carotid artery disease and stroke (TIA or Stroke)*
  • Lower extremity arterial disease (PAD)**
  • Upper extremity arterial disease
  • Abdominal aortic aneurysm (AAA)
La Jolla Vein Care Registered Vascular Technologist (RVT)

Vein Care Delivered To Your Home: In-home ultrasound diagnostics

We now offer mobile ultrasound services!

Right now we want you to stay home.  But, that won’t stop us from helping you!

Enjoy a thorough vascular assessment from the convenience of your own home.

  1. Have your physician consultation, conservative management or follow-up visit by telemedicine (video) or by telephone (it’s your preference!).
  2. For the ultrasound portion, our Registered Vascular Technologist (RVT) will bring the same hospital grade quality ultrasound technology to your home, while taking proper COVID precautions and utilizing personal protective equipment (PPE).

Ultrasound Services include:

  1. Complete venous reflux study and vein mapping
  2. Deep Venous Thrombosis (DVT study for blood clots)
  3. Arterial study of the legs
  4. Follow-up, post-procedure checks
  5. Carotid Artery Screening
  6. Abdominal Aortic Aneurysm Screening

 

Whether you have immediate concerns about leg pain, discomfort, blood clots, or are looking for a first-time consultation or continued follow-up care, we are here for you.

 

Call now to schedule your in-home ultrasound diagnostics and physician telemedicine visit.

Call 858-550-0330

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Molina insurance now accepted!

 

 

La Jolla Vein Care is pleased to announce that we now accept Molina Healthcare.  Our hope is that will allow access to our services to more patients.  Please contact us with any questions at (858) 550-0330 or email us at info@lajollaveincare.com.

 

We look forward to helping our new Molina Patients with their Vascular needs.

Ultrasound of the leg

What Leg Vein Ultrasound Can Uncover About Your Veins

Most vein disease is not visible to the naked eye.

What Leg Vein Ultrasound Can Uncover About Your Veins: blood clots and leaky valves

We can see beneath the surface of the skin with ultrasound. Duplex ultrasound combines Doppler flow information and conventional imaging information, sometimes called B-mode, to allow physicians to see the structure of your blood vessels. Duplex ultrasound uses sound waves to get images of your blood vessels.  It also helps determine how fast blood moves through the vessels. It can also be useful to estimate the diameter of a blood vessel as well as the amount of obstruction, if any, in the blood vessel. Using duplex ultrasound technology, the structure of your blood vessels, the valve function, the movement of your red blood cells and direction of blood flow through the vessels, and any blockages or blood clots can be seen.

Venous Reflux (leaky valves)

The Duplex Ultrasound examination allows us to visualize the blood vessels that are not visible to the naked eye, even blood vessels that are deep within the muscles.  Ultrasound looks at deep and superficial veins in the legs to check for venous-valvular incompetence (the underlying condition that causes varicose veins). The ultrasound examination is used to both identify the veins that have faulty valves and to map the anatomy of the veins, creating a ‘road map.’  This is necessary to make an accurate assessment of the cause and extent of the varicose veins, as well as to formulate the best treatment plan.  This should be done for any individual being evaluated for varicose veins, leg swelling, patients who have failed prior treatment, patients who are symptomatic and in some patients with certain anatomic patterns of spider veins.

Before your test:  This study does not require any preparation. You should not wear your compression stockings the same day as the examination.  Make sure to be hydrated.

How long does it take? An ultrasound only checking for blood clots typically takes less than 30 minutes. An ultrasound that looks at both the deep and superficial veins including mapping is less than 60 minutes, the part of this exam that checks if the valves are leaky, is performed

Ultrasound of the leg

Ultrasounds of the leg veins that look for leaky valves (venous reflux) are usually performed in the standing position.

in the standing position.

laser vein ablation

Laser Vein Ablation for Varicose Veins: What is it?

Laser Vein Ablation Uses Heat to Treat the Underlying Cause for Varicose Veins

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.

The laser vein ablation procedure may be offered for backwards flow (or “reflux”) in your saphenous vein(s).  The great and small saphenous veins are the two main superficial veins that run along the inner thigh/ calf and the back of the legs, respectively. Some people have anatomic variations where the small saphenous vein in the back of the calf extends to the thigh. Many people also have reflux in their anterior or posterior saphenous veins.

This minimally invasive procedure can be performed in the office in less than 30 minutes and patients return to their usual level of activity the same day.

How does the treatment work?  The skin is numbed with lidocaine, then a tiny wire and catheter are inserted into the vein.  The catheter delivers laser energy to the vein wall, causing it to seal shut. The remaining healthy veins continue to bring blood back to the heart.

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 typically taken at check-in. Your leg will be prepped for the sterile procedure, then the doctor will perform an ultrasound to localize the vein.  Through a tiny puncture in the skin, the radiofrequency catheter is passed though vein under ultrasound guidance.  We then use a needle to administer a combination of cool saline and local anesthetic around the vein.   This solution numbs the vein and insulates it from the surrounding tissue.  Your doctor will then treat the vein painlessly with laser energy.  Once your vein has been treated, we will help you into your compression stocking, which you will wear for 72 hours continuously.  You will walk for 30 minutes prior to getting in your car.

What should I do after treatment?   You should walk 30 minutes twice daily after treatment.  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®).

What should I avoid after treatment?  For at least two weeks after treatment, you should avoid air travel, 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.

laser vein ablation

Endovenous laser vein ablation therapy (EVLT) uses a tiny catheter to seal incompetent veins shut.

What are the possible adverse effects?   Expect some bruising over the injection sites, which fades over about two weeks.  The skin overlying larger varicose veins may also develop some temporary inflammation and/or brown “hyperpigmentation” as the blood products within those veins are absorbed by the body.  Less common compilations (less than 2% of patients) include clots within the deep veins or a temporary area of skin numbness over a branch of a skin nerve that travels close to a vein.

La Jolla Vein Care

Benefits of Online MD Consultations for Varicose Veins

Connect with a vein expert from the convenience of your own home.

Benefits of Telehealth for Varicose Vein Patients

Many of us have found ourselves at home with time to think about health concerns, we have not had time to address.

one of our 10 exam rooms at la jolla vein care clinic

Common questions our patients are asking via online / telehealth consultations are:

  1. Should I be concerned about my leg pain?
  2. What is causing my leg pain?
  3. I have lumpy veins, are these varicose veins?
  4. I have blueish colored spots on my legs, what are these?
  5. What are the treatment options for varicose veins?
  6. Why are my legs always so fatigued?
  7. Do my varicose veins pose a health problem?
  8. Should I be concerned about varicose veins?
  9. Are these veins normal?
  10. What are these ugly leg veins?

Now is the time to ask all the questions you have ever had about your legs and vein condition.

Although we cannot see you in person, by taking a thorough history and listening to your concerns, and if you like you can send a picture of your legs by text, we can discuss your symptoms and help determine the cause of your symptoms. Because we specialize in venous disease, a lot of information can be obtained from your pictures, such as the pattern of vein disease we see on your legs is often correlated to underlying vein disease. As a result, we can come up with a preliminary treatment plan, which will then be confirmed by an ultrasound examination at our state-of-the-art diagnosis and vein treatment center, after April 30th, 2020.

Here’s a summary of the benefits of an online consultation for varicose veins:

  1. Discuss your concerns with the doctor
  2. If vein treatment is desired, a preliminary treatment plan will be made, based on the appearance / pattern of veins on your legs. An ultrasound will later be required.
  3. Learn treatment options for your condition
  4. Start conservative management today- The doctor will discuss things you can do to help your legs feel better today. Insurance also requires 3 months of documented conservative management. Start your conservative management today, so you can start treatment in 3 months from now!

Telehealth Consultations are covered by most insurance types. Schedule your telehealth consultation today with Dr. Sarah Lucas:

858-550-0330 or email anna@lajollaveincare.com.

telemedicine from home

Vein Care Telemedicine during COVID

We’re here for you!

telemedicine from home

talk to our board certified doctors, vein specialist from the convenience of your home.

Connect with one of our board certified physicians at the convenience of your home.

While we remain focused on providing exceptional care, we feel it is in everyone’s best interest to move to a contact-free environment. Effective March 19th, 2020  and with a tentative ending on April 26th,  2020, the office will be closed. However, physicians will be available to patients by phone or via video conference (telemedicine) during normal business hours.

Did you know you can start your conservative management now?

Have you had concerns about your legs you have always wanted to discuss or ask about?

Now is the time. You can text us pictures of areas of concern on your leg/s ahead of time.

How to reach us:

To schedule a phone or telemedicine visit with our physicians, or any questions please call us at (858) 550-0330 or email anna@lajollaveincare.com.

Alternatively, you can reach us with the chat function below or text (858) 295-3347.

We are available between the hours of 8am to 5pm, Monday through Friday.

before and after varicose veins

Varicose Veins in Men Common

There is a misconception that varicose veins only affect women. Although they affect women 3x more commonly than men, millions of men in America unnecessarily suffer with varicose veins.

Men, get back to enjoying an active lifestyle

Do your legs feel tired, achy, heavy or restless at night? Have you noticed that your legs swell or feel worse after sitting or standing for long periods of time? Has your tennis or golf game suffered lately? Perhaps you have slowed down significantly while performing your exercise or running routine? If you answered yes to any of the above, you may be suffering from consequences of venous insufficiency.

​There are a lot of myths and misconceptions about vein disease out there. You may hear that vein problems are only a cosmetic concern or that they only affect women. Truthfully, even some clinicians don’t seriously consider vein disease to significantly affect a patient’s quality of life. However, in addition to the appearance of your legs, vein problems can significantly affect your daily living.

​In the San Diego Population Study, a study of 2,400 men and women living in the San Diego area, UCSD researchers found that about 1 in 6 men (15%) had visible varicose veins and about 1 in 4 men (24%) had significant vein problems (reflux, obstruction) when they looked with an ultrasound machine.1 Furthermore, these researchers found that individuals with more advanced stages of vein problems had worse physical conditioning and quality of life.2 While the results from these studies are concerning and scary, the good news is we have made significant advances in minimally invasive vein treatment over the past twenty years. Most vein problems of the legs can be treated in office, under local anesthetic, and in less than an hour with a few sessions. Most patients can return to work on the same day of their treatments.

​If you think your veins may be causing you problems you weren’t previously aware of, please call (858-550-0330) and schedule a comprehensive evaluation at La Jolla Vein Care.

Sincerely,

Dr. Jonathan T. Unkart

Vascular Specialist

 

References

1.​Criqui MH, Jamosmos M, Fronek A, Denenberg JO, Langer RD, Bergan J and Golomb BA. Chronic venous disease in an ethnically diverse population: the San Diego Population Study. Am J Epidemiol. 2003;158:448-56.

2.​Kaplan RM, Criqui MH, Denenberg JO, Bergan J and Fronek A. Quality of life in patients with chronic venous disease: San Diego population study. J Vasc Surg. 2003;37:1047-53.

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Dr. Sarah Lucas in the News

If you missed Dr. Sarah Lucas, of La Jolla Vein Care on KUSI News, you can see her here on our media page.

Dr. Lucas discusses venous insufficiency in pregnancy, how many women it affects and how it affects them.