21, 6, 2022

Non Invasive Vascular Laboratory

2022-05-23T15:49:54-07:00

Noninvasive Vascular Laboratory

The Non Invasive Vascular Laboratory at La Jolla Vein & Vascular utilizes advanced, noninvasive, diagnostic, medical ultrasound technology while ensuring high quality results to detect diseases that may affect blood flow in the arteries and veins.  We utilize “state-of-the-art” color duplex ultrasound imagers and indirect testing equipment.

The Vascular Lab offers the convenience of:

  • Non-invasive testing
  • Same-day imaging appointments
  • Follow-up clinic visits with our on-site vascular team
  • Appointments at multiple locations including La Jolla, Poway, Chula Vista, and Solana Beach.

What is Duplex Ultrasound

non invasive

The non invasive Duplex ultrasound involves using high frequency sound waves to look at the speed of blood flow, and structure of the blood vessels. The term “duplex” refers to the fact that two modes of ultrasound are used, Doppler and B-mode. The B-mode transducer obtains an image of the vessel being studied. The Doppler probe within the transducer evaluates the velocity and direction of blood flow in the vessel.

Types of Ultrasound Testing Offered:

Direct testing (duplex imaging)

Venous Non Invasive

  • Deep Vein Thrombosis- upper or lower extremity
  • Venous Reflux

Arterial Non Invasive

  • Abdominal Aorta
  • Abdominal Aortic Aneurysm (AAA) Screening- must meet criteria of SAAAVE Act
  • Carotid Duplex
  • Lower Extremity Duplex

Indirect testing (non-imaging)

Arterial –Segmental pressures and waveforms (P&Ws), upper or lower extremity

 

 For more information and to book a consult, please give our office a call at 858-550-0330.

For more information please check out our Youtube Channel at this link.

Non Invasive Vascular Laboratory2022-05-23T15:49:54-07:00

17, 5, 2022

Treatments for Benign Prostatic Hyperplasia (BPH)

2022-04-29T16:24:09-07:00

Treatments for Benign Prostatic Hyperplasia (BPH)

benignprostatichyperplasia

With various Benign Prostatic Hyperplasia (BPH) treatments available, the best choice for you depends on various factors. These factors included your prostate size, age, overall health, and the amount of discomfort you are experiencing. If the symptoms are tolerable, trying natural treatment such as lifestyle changes may help. Some of the natural treatment includes;

  • urinating immediately you feel the need
  • going to the washroom to urinate frequently
  • Keep off using OTC medications such as antihistamines or decongestants that make bladder emptying hard.
  • Avoiding taking caffeinated or alcoholic drinks after dinner
  • Practicing Kegel exercise to strengthen the pelvic muscles
  • Regular exercises
  • Keep yourself warm; cold weather makes the symptoms worse.

Prostate Artery Embolization (PAE)

 

La Jolla Vein & Vascular is excited to do this new procedure for our clinic. Prostate artery embolization (PAE) is an innovative procedure that helps treat urinary symptoms caused by benign prostatic hyperplasia without sexual side effects. Although it is now common in the United States, the procedure was developed in Europe and South America. Patients who suffer from BPH encounter multiple urinary and sexual issues. Enlarged prostate makes urine flow very slow, leading to urinary infections that may affect your kidney. While various medications and surgical treatments are available for BPH, they often retrograde ejaculation, a severe sexual dysfunction. As mentioned earlier, PAE is an advanced treatment, which offers fast results without interfering with the patient’s sex life.

 

Treatment for Benign Prostatic Hyperplasia (BPH)

Prostate artery embolization is a relatively new and safer outpatient procedure performed by interventional radiologists to help treat benign prostatic embolization (BPH), commonly known as enlarged prostate.

For more information on vein and vascular treatment please visit our YouTube Channel.

Treatments for Benign Prostatic Hyperplasia (BPH)2022-04-29T16:24:09-07:00

What is Benign Prostatic Hyperplasia (BPH)?

2022-04-29T16:03:54-07:00

What is Benign Prostatic Hyperplasia (BPH)?

Benign prostatic hyperplasia (BPH) is an enlarged prostate. As a man grows old, the prostate undergoes two primary growth cycles. The first cycle usually happens during early puberty where the prostate’s size doubles. The second cycle begins at the age of 25 years and continues for the rest of the life. Benign Prostatic Hyperplasia (BPH) usually develops during the second growth cycle.

benignprostatichyperplasia

During the second phase, the prostate enlarges, pressing against the urethra. As this happens, the bladder wall also becomes thicker. The condition causes the narrowing of the urethra and urinary retention. The bladder tends to weaken and fail to empty fully, resulting in some urine being left in the bladder. This condition causes uncomfortable symptoms such as urinary tract, bladder, and kidney problems.

The prostate is a tiny, muscular gland that surrounds the urethra. The gland is responsible for the most fluid in the semen. The prostate’s muscular action assists in propelling semen and fluid through the penis during ejaculation. Prostate enlargement is referred to as benign prostatic hyperplasia. (BPH) develops when the prostate gland cells start to replicate. As the cells multiply, the prostate gland swells, pressing against the urethra and obstructing the urine flow. 

Benign Prostatic Hyperplasia (BPH) is benign, meaning it does not cause or lead to cancer. However, the condition leads to uncomfortable symptoms and complications that can affect the quantity of life. (BPH) is a common condition affecting about 50% of all men aged between 51 and 60 years. The condition also affects up to 90% of men aged over 80. 

For more information on vein and vascular treatment please visit our YouTube Channel.

What is Benign Prostatic Hyperplasia (BPH)?2022-04-29T16:03:54-07:00

Process of being diagnosed with Peripheral Arterial Disease

2022-04-28T19:14:18-07:00

Peripheral Arterial Disease – Diagnosis

At La Jolla Vein & Vascular, we have highly trained physicians who offer a comprehensive diagnosis to develop customized treatments of Peripheral artery disease (PAD). We understand that no two patients’ conditions are similar. Our full-service vascular lab provides state-of-the-art testing to ensure that our physicians address each patient case quickly and accurately. Our doctors and nurses also have broad experience in this field and use advanced tools to achieve limb-saving results even for challenging, impaired patients. Our PAD diagnosis procedure involves the following:

peripheral arterial disease

Detailed Physical Exam

To help diagnose Peripheral Arterial Disease, our skilled doctor will start by doing a thorough physical examination. The doctor will also want to learn about your signs, symptoms, personal health history, risk factors, and family health history. The doctor will ask you several questions regarding your medical conditions, such as diabetes, heart disease, and kidney disease. They will also ask you whether you experience pain or cramps in your leg while walking or exercising.

The doctor will also ask about your family history of PAD and other heart diseases. You will also discuss your smoking habit, either current or in the past. After gathering the information, the doctor will proceed to perform a detailed physical examination. The process involves checking for weak pulses in your leg, listening for poor blood flow in the legs using a stethoscope. The physician will also check for any problems on your legs, such as sores, swelling, and pale skin.

Detailed Physical Exam

Ankle-brachial index (ABI)

Ankle-brachial index (ABI test) helps diagnose PAD. This test usually compares the blood pressure in your arm with the blood pressure in your ankle. The doctor usually uses a pressure cuff together with an ultrasound device. Sometimes, the physician may request you to walk on a treadmill and have the doctor take the readings before and immediately after the exercise. The procedure will help the doctor to capture the severity of the narrowed arteries.

 

Arterial Ultrasound

La Jolla Vein & Vascular doctors also use ultrasound-guided procedures to determine whether a specific vein or artery is blocked or open. The procedure is non-invasive, meaning that you will not experience any pain. The technique visualizes the artery with sound waves that measure the blood volume that flows in the veins and arteries. After the procedure, the patients receive a thorough consultation. The doctor will recommend the most effective treatment option to help promote blood flow to the feet and leg.

The treatment will help reduce leg pain, promote healing of sores and increase the mobility of the affected limb. Doctors utilize two main ultrasound methods. The first method is the Doppler ultrasound utilized to locate areas with blockages or reduced blood flow. The procedure involves using a handheld device that sends sound waves through the arteries to measure how fast blood flows. The second method is the segmental Doppler pressure testing that checks various parts of the legs for blocked or narrowed arteries. The procedure is similar to the ABI test, but the ultrasound device will amplify the sound of blood flow, making it easy to measure blood pressure and diagnose peripheral arterial disease. 

 

Angiography (venography)

Angiography is minimal invasive testing that helps to visualize and diagnose blockages inside veins and arteries. In this procedure, the physician will insert a thin tube that injects a special dye that enables blood vessels to appear on an X-ray. As the dye is introduced to the arteries and veins, fluoroscopy imaging captures the detailed images to see the extent of blockages in the arteries.

 

Blood Tests

Doctors also take a sample of your blood to measure the levels of cholesterol and triglycerides. Blood samples are also used to check for diabetes.

 

Magnetic Resonance Angiography (MRA)

MRA tests are conducted to examine the structure of the arteries in your leg. However, the doctor will speak to you before using the procedure. Magnetic resonance angiography is not recommended for people with metal implants in their bodies.

For more information on Vein and Vascular conditions, please check out our Youtube Channel.

Process of being diagnosed with Peripheral Arterial Disease2022-04-28T19:14:18-07:00

What is Peripheral Arterial Disease (PAD)

2022-04-28T18:54:59-07:00

Peripheral artery disease is a subset of vascular disease,also referred to as peripheral arterial disease (PAD), which develops when excessive plaque buildup on the artery walls causing the narrowing of the arteries.

peripheral artery

The arteries deliver oxygen-rich blood from the heart to other parts of the body. When plaque builds up, it usually restricts the flow of blood, oxygen, and glucose. The obstruction causes pain in the leg as the muscles and tissues are starved for oxygen and other nutrients from the blood. While the pain usually occurs in your legs primarily, it can also be felt in other parts of the body, including your arms, stomach, hip, head, and kidneys.

Are You at Risk for Peripheral Arterial Disease (PAD)?

In most cases, the PAD symptoms are on the lower extremities. You may experience some pain, craping, or tiredness in your hip or leg muscles when climbing stairs or walking. However, the pain usually goes away with rest, only to resurface when you start walking again. Individuals suffering from peripheral arterial disease are at a high risk of coronary artery disease, stroke, or heart attack. Even worse, if left untreated, the condition can lead to gangrene and amputation.

 

Peripheral Arterial Disease – Symptoms

 

The most common symptom of Peripheral arterial disease is claudication. The fat and cholesterol build up on the artery walls cause a lack of blood flow, causing a condition referred to as ischemia. Ischemia is a condition that results when there is a greater demand for oxygen than the supply.

Claudication is a condition that causes cramping in the legs and buttocks. As mentioned, the pain and clamping flares up when you start to walk and subsides when you rest. Intermittent claudication affects about 50 percent of individuals suffering from peripheral artery disease. Some of the other common symptoms include loss of hair around the ankles, numbness or coldness in your feet.

Pain and cramping while walking may lead to a more sedentary lifestyle, meaning that the individual will burn few calories and add weight. An increase in weight also increases cholesterol, blood pressure, and other heart disease risk factors. The claudication severity often varies from mild discomfort to debilitating pain, making it hard for you to walk or perform other types of physical activities. 

PAD

Other common symptoms of the peripheral arterial disease include;

  • In extreme cases, an open wound or ulcer occurs on your toes or feet. These extreme cases lead to non-healing ulcers. The ulcer can progress to gangrene, making it hard for you to walk. In such a scenario, immediate medical attention is necessary.
  • Weakness or numbness in your legs
  • Coldness in your lower feet, especially when you find one foot is colder than the other one.
  • Experiencing pain in your feet or toes while you are resting
  • Sores on the legs, feet, and toes that do not heal
  • Slower toenails growth
  • Change in the color of your feet
  • Erectile dysfunction in men can be treated by prostate arterial embolization (PAE), which also treats benign prostatic hyperplasia (BPH)
  • Weak pulse in your feet or legs
  • Developing shiny skin on your legs
  • Having pain in your arms, especially when writing, knitting, or performing manual tasks

As the peripheral disease progresses, you may start to experience pain even when you are lying down. In extreme cases, the pain becomes intense enough to distract your sleep. Resting your legs by hanging them at your bed edge or walking around the room helps stimulate blood flow, relieving the pain temporarily.

 

What is Peripheral Arterial Disease (PAD)2022-04-28T18:54:59-07:00

Symptoms and signs of non healing ulcers and wounds

2022-04-28T17:32:09-07:00

Symptoms of Non-Healing Ulcers

 

As we’ve seen, there is a very wide range of causes of non healing ulcers and wounds that may contribute to the formation and persistence of non-healing ulcers. It follows that the methods or treatment options at the disposal of healthcare professionals will also be varied.

You shouldn’t allow a wound to fester for weeks on end before seeking professional assistance, especially if you fall under one or more of the risk categories we’ve outlined above. The following are some warning signs to look out for:

  • -Darkening or bluish discoloration around the wound edges
  • -Significant pain around the wound that persists without improvement or progressively grows worse
  • -Foul odor or smell emanating from the wound
  • -Swelling and redness emanating from the wound and spreading to surrounding skin and tissue
  • -Continuous leaking, draining, or weeping from the wound

Notice that these symptoms of non healing ulcers and wounds are mostly indicative of infection. This is a good measure as it often indicates a failure of the body’s natural mechanisms to deal with the wound through its normal processes. The rapid and timely intervention will be called for to forestall further tissue damage and complications.

 

ulcer4

Treatment of Non-Healing Wounds

 

Doctors will discuss the available options for non healing ulcers and wounds with their patients in order to arrive at the best possible options, but the type and severity of the wound will be the decisive point of consideration. These measures include:

Compression Wrapping

Specialized Dressings and Topical Medication

Patient Self-Care and Education

Negative Pressure Therapy (NPWT)

Surgery

Growth Factor Therapy

Debridement (removal of dead tissue)

Symptoms and signs of non healing ulcers and wounds2022-04-28T17:32:09-07:00

Causes of Non-Healing Ulcers & Wounds

2022-04-28T17:24:16-07:00

Non-healing ulcers & wounds do not follow the usual healing process and are referred to as chronic wounds should they persist beyond 3 weeks. Such wounds can be a heavy burden to live with for anyone. Still, the board-certified vascular surgeons and specialists at La Jolla Vein & Vascular are dedicated to administering effective treatment and management solutions to all patients so they may resume a healthy, productive, and pain-free life.

Types of Non-Healing Ulcers

In general, patients will present with one of three categories of non healing ulcers & wounds, with these categories being broadly defined by the major causative factors allowing for their development. These are:

Arterial or Venous Ulcers

 

These are found to account for between 70% up to 90% of non-healing wounds or non-healing ulcers. Mostly occurring in elderly patients, they are believed to come about as a result of a failure of the valves in a person’s blood vessels of both arteries and veins. These valves are responsible for preventing the backflow of blood as it passes within them. The consequent outcome is a lack of nutrient and oxygen-rich blood from reaching the affected tissues and sets up the conditions favoring non-healing wounds.

 

Pressure Ulcers

 

These are ulcers that are brought about by the restriction of blood flow to certain regions of the body due to the persistent and prolonged application of pressure upon them. It is mostly encountered among patients with full or partial paralysis and those who are bedridden for extended periods.

 

Diabetic Ulcers

 

These are also highly prevalent chronic wounds, and are on the increase among patients owing to the ever-increasing cases of diabetes among the population. In fact, the prevalence of chronic wounds among diabetics makes this demographic 15% more likely to have to undergo limb amputation as a complication of the condition.

The causes of non healing ulcers & wounds: 

footulcer3

The underlying factors contributing to the risk of developing a non-healing ulcer or wound are widely varied. What they have in common is their ability to interfere with the way the body normally functions with regard to wounds.

 

Nerve Damage (Neuropathy)

Circulatory System Issues

Underlying Health Conditions

Nerve Damage (Neuropathy)

 

Non healing ulcers & wounds are prevalent in people living with certain circulatory ailments such as atherosclerosis, diabetes, alcoholism, etc. In a healthy person, the nerves will send signals to the brain whenever pain or discomfort is experienced in any body tissues. Neuropathy makes this system non-functional; tissue can be damaged without warning signals being sent to the brain. This will prompt the person to change position or remove the object, causing injury. Over time, the affected area might see the development of an ulcer.

Circulatory System Issues

 

A person’s circulatory system is responsible for delivering blood rich in oxygen and nutrients to all the tissues in the body that need it. Without it, tissues will begin to die. Due to their extremity (distance from the heart) and the effect of gravity, a person’s feet will often be the first problem area for a person with an impaired circulatory system. Peripheral artery disease (PAD) is a particularly culpable condition in this instance as it may lead to numbness, skin discoloration, severe pain, ulcers, or even the patient’s demise if left unchecked.

Underlying Health Conditions

 

The formation of non-healing ulcers will indicate that an advanced stage of certain conditions has been reached in a patient. These conditions include high blood pressure, diabetes, kidney failure, high cholesterol, or peripheral artery disease (PAD). These conditions contribute to the formation of ulcers by causing ischemia, or the interruption of oxygenated blood to all parts of the body, or by damaging the nerves in the wound areas.

Contributing Lifestyle Habits

 

Some various habits and lifestyles will place patients at a heightened risk of developing non-healing ulcers. Smoking, for instance, has the effect of narrowing the vessels carrying blood to body tissues, thus increasing one’s chances of developing ulcers. A sedentary lifestyle involving little to no active movement will also carry the risk of encouraging ulcer development due to the constant pressure applied to certain tissues. Old age is also a factor here, as our skins will gradually lose their ability to repair themselves as quickly and efficiently as they once did.

 

Causes of Non-Healing Ulcers & Wounds2022-04-28T17:24:16-07:00

What are Non Healing Ulcers & Wounds?

2022-04-28T17:17:13-07:00

Non-Healing Ulcers &  Wounds

 

We might all be familiar with non healing ulcers & wounds in a general manner, but certain types of ulcers behave quite differently due to various contributing factors. These are non healing ulcers or non healing wounds, and if not treated with care and in good time, such wounds can pose a serious risk to the patient’s health. Severe cases may lead to amputation of the affected limbs or loss of life in the most extreme circumstances. The nonhealing ulcers cases we treat here at La Jolla Vein & Vascular fall under peripheral arterial disease (PAD) and a subcategory of arterial disease.

Non-healing wounds or ulcers do not follow the usual healing process and are referred to as chronic wounds should they persist beyond 3 weeks. Such wounds can be a heavy burden to live with for anyone. Still, the board-certified vascular surgeons and specialists at La Jolla Vein & Vascular are dedicated to administering effective treatment and management solutions to all patients so they may resume a healthy, productive, and pain-free life.

foot ulcer

Types of Non-Healing Ulcers

In general, patients will present with one of three categories of non-healing ulcers, with these categories being broadly defined by the major causative factors allowing for their development. These are:

Arterial or Venous Ulcers

 

These are found to account for between 70% up to 90% of non-healing wounds or non-healing ulcers. Mostly occurring in elderly patients, they are believed to come about as a result of a failure of the valves in a person’s blood vessels of both arteries and veins. These valves are responsible for preventing the backflow of blood as it passes within them. The consequent outcome is a lack of nutrient and oxygen-rich blood from reaching the affected tissues and sets up the conditions favoring non-healing wounds.

 

Pressure Ulcers

 

These are ulcers that are brought about by the restriction of blood flow to certain regions of the body due to the persistent and prolonged application of pressure upon them. It is mostly encountered among patients with full or partial paralysis and those who are bedridden for extended periods.

 

Diabetic Ulcers

 

These are also highly prevalent chronic wounds, and are on the increase among patients owing to the ever-increasing cases of diabetes among the population. In fact, the prevalence of chronic wounds among diabetics makes this demographic 15% more likely to have to undergo limb amputation as a complication of the condition.

The high amputation rate among diabetics is attributable, in part, to the neuropathic effects of the ailment. Neuropathy leads to a lack of pain perception in the affected individual, meaning that they may be entirely unaware of minor wounds on their feet and legs in good time, allowing for their infection or repeat injury. It is also made more likely by the immunosuppressive effects of the condition, which makes the patient more vulnerable to infection.

foot ulcer2

What are Non Healing Ulcers & Wounds?2022-04-28T17:17:13-07:00

Varicose Veins: Patient Transformations Part 2

2022-04-28T14:52:04-07:00

What are varicose veins?

Varicose Veins are the twisted, bulging veins just beneath the surface of the skin. They are swollen, twisted veins that you can see just under the surface of the skin. These veins usually occur in the legs, but they also can form in other parts of the body, and are very common.

Varicose veins are caused by leaky vein valves, which allow blood to pool within the veins causing them to stretch and become enlarged. They can be an isolated finding, but the majority of the time, they are caused by underlying venous reflux disease. Venous reflux disease is also known as venous stasis, venous insufficiency or venous incompetence. Reflux may occur in the deep and/or superficial leg veins.

What are the symptoms?

The symptoms can include:

  • Aching, tenderness
  • Heaviness, fatigue
  • General restlessness in the legs
  • Burning pain
  • Throbbing pain
  • Itching
  • Leg cramps, particularly at night
  • Ankle swelling
  • Skin discoloration at the ankle
  • Skin ulcers above the ankle

Over time, complications can develop from untreated veins. These include:

  • Superficial phlebitis (painful inflammation of the vein)
  • Superficial thrombophlebitis (blood clots within the varicose veins)
  • Spontaneous vein hemorrhage (the vein can rupture spontaneously)
  • Skin discoloration and eczema around the ankle (venous eczema)
  • Skin sores or ulcers usually near the ankle

Duplex ultrasound technology is used to evaluate the veins beneath the surface of the skin. The ultrasound allows us to see if the valves are leaky; it can detect the direction of blood flow and also detects blockages in the veins, for example from blood clots or scars within the veins from previous clots. The ultrasound will determine exactly which veins are ‘bad’ or incompetent. Reflux may be detected in the deep veins (within the muscle), the great and small saphenous veins, and/or branches of the saphenous veins. This will help determine the treatment plan.

La Jolla Vein Care Before and After Transformations:

At La Jolla Vein Care, we are here for our patients from beginning to the end. We love seeing the transformations that take place. Below are a few cases from our patient transformations from before varicose vein treatment to after vein treatment.

varicose veins varicose veins varicose veins varicose veins

Varicose Veins: Patient Transformations Part 22022-04-28T14:52:04-07:00

Varicose Veins and Swelling

2022-04-28T14:48:10-07:00

Varicose Veins and Swelling

Leg swelling (is also known as edema), is a common complaint related to varicose veins and underlying venous insufficiency. It can be present simply from underlying venous insufficiency without visible signs of varicose veins or spider veins. As a result, a venous insufficiency study by duplex ultrasound scanning is part of the recommended work-up for this undesirable symptom. The swelling usually affects the ankles.  Most people with vein-related symptoms, experience progressive swelling throughout the day, that is worse at night time and improved in the morning (they usually wake up with normal appearing legs in the morning but by night-time, shoes may feel tight.) When it is vein-related, it is worse at the end of the day, with prolonged standing, sitting or with air travel, heat and menstruation.  The degree varies from one person to another.

Compression stockings and leg elevation will help reduce swelling.   If the swelling can be attributed to the varicose veins or venous insufficiency, correction of the underlying vein problem will reduce it.

swelling

It is a common symptom of varicose veins and venous insufficiency. The legs often feel heavy. It is common to notice sock lines around the ankles by the end of the day.

Conservative management and lifestyle changes can ease the symptoms of varicose veins and swelling and help reduce complications such as thrombophlebitis (blood clots within veins) and vein rupture, but do not cause the veins to vanish. These measures are helpful if an individual is not a candidate for vein procedures or wishes to delay interventional treatment.

Varicose veins can cause swelling and at La Jolla Vein Care, we offer numerous treatments for our patients. Check out a few of our favorite treatments that help reduce the swelling and varicose veins. Please call our office to schedule a consultation with one of our vein specialists to help in reducing swelling and other varicose vein symptoms.

Varicose Veins and Swelling2022-04-28T14:48:10-07:00
Go to Top