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ESP

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Vein Care & Aesthetic Solutions

Venous Disease Conditions Treated

We diagnose and treat a wide range of venous conditions, including:

Advanced Vein Treatment Options

Our clinic offers state-of-the-art, minimally invasive vein treatments:

Thermal Ablation (Saphenous Vein Reflux Treatment)

Foam & Adhesive-Based Vein Therapies

Venous Diagnostic Ultrasound Services

We provide accurate vein diagnostics using cutting-edge ultrasound technology:

Cosmetic Vein Treatments

Enhance your appearance and confidence with our cosmetic vein services:

Spider & Reticular Veins Treatment

Laser Skin Treatments

Rejuvenate your skin with our non-surgical laser therapies:
  • Laser Acne & Acne Scar Treatment
  • Cherry Angioma Removal
  • Erbium Laser Skin Resurfacing
  • Hollywood Carbon Laser Facial
  • IPL Photofacial Skin Rejuvenation
  • Laser Hair Removal
  • Sun Damage & Pigmentation Treatment
  • Rosacea & Facial Vein Therapy
  • Broken Capillaries & Spider Vein Removal

Microneedling with SkinPen®

Naturally stimulate collagen for smoother, healthier skin:

SkinPen Microneedling Helps Improve:

  • Fine Lines & Wrinkles
  • Acne Scars & Surgical Scars
  • Hyperpigmentation & Melasma
  • Uneven Skin Texture & Tone

Lymphatic Wellness Services

Support detoxification and circulation through:
  • Electro-Lymphatic Therapy
  • Pneumatic Compression Therapy

Conservative Vein Management

Our holistic approach includes lifestyle and supportive therapies:
  • Compression Stocking Fitting
  • Vasculera® Supplements
  • Patient Education & Preventive Guidance

Why Choose Us?

  • Board-certified vein specialists
  • State-of-the-art diagnostic and treatment technology
  • Minimally invasive procedures with little to no downtime
  • Personalized care plans
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Dr. Amanda Steinberger is a Harvard-trained, board-certified vascular interventional radiologist. She specializes in a broad range of superficial vein disease including varicose veins, spider veins, venous leg ulcers, lymphedema and cosmetic laser vein treatments. Dr. Steinberger sees patients in our La Jolla Office.

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Can I get insurance coverage for my vein treatment?
Depending on your insurance plan, you may or may not have out of pocket expenses. We work with your insurance providers to maximize your insurance coverage and provide a complete overview of your treatment cost. We believe in cost transparency and will provide a cost estimate of any anticipated out of pocket expenses. Cost is important. We can work with your insurance to find out this information today!
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Can I get insurance coverage for my vein treatment?
With Molina insurance plans, most patients should not have out of pocket expenses. We work with Molina to maximize your insurance coverage and provide a complete overview of your treatment cost. We believe in cost transparency and will provide a cost estimate of any anticipated out of pocket expenses. Cost is important. We can work with your insurance to find out this information today!

ClosureFast™ an endovenous radiofrequency ablation (RFA) procedure

for the backward flow of blood (or “Venous reflux”) in your saphenous vein(s). The great saphenous veins and small saphenous veins are the two main superficial veins of the leg. They run along the inner leg and the back of the leg, respectively.

This minimally invasive procedure can be performed in the office in less than an hour and patients usually return to their usual level of activity the same day.
Video below shows the proceedure.
Read our Patient Handout
Before and After Care information
HOW DOES THE TREATMENT WORK?
The skin is numbed with lidocaine, then a tiny wire and the Closurefast® catheter are inserted into the vein. The catheter delivers radio-frequency energy to the vein wall, causing it to seal shut. The remaining healthy veins continue to bring blood back to the heart.

ENDOVENOUS LASER ABLATION FOR SAPHENOUS VEIN REFLUX

VenaCure is an endovenous laser ablation (EVLA) procedure for backwards flow (or “reflux”) in your saphenous vein(s).

Laser is also referred to as endovenous laser ablation therapy (EVLT). The great and small saphenous veins are the two main superficial veins of the leg. They run along the inner leg and the back of the leg, respectively.

This minimally invasive procedure can be performed in the office in less than an hour and patients return to their usual level of activity the same day.
Read our Patient Handout
Before and After Care information
Video below shows the proceedure.
HOW DOES THE TREATMENT WORK?
The skin is numbed with lidocaine, then a tiny wire and the laser 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.

RADIO FREQUENCY ABLATION for PERFORATOR VEIN REFLUX

Radiofrequency perforator ablation is performed on perforator veins, short connections between your deep and superficial veins. Perforator veins can suffer the same sort of valve damage and retrograde blood flow (venous reflux) as other veins. Most patients with vein disease who experience skin changes, (that also may result in leg ulcers if left untreated) have reflux in perforator veins near their ulcers, as well as in the superficial or deep veins.
Video below shows the proceedure.
Read our Patient Handout
Before and After Care information
HOW DOES THE TREATMENT WORK?
Radiofrequency perforator ablation is an outpatient procedure, performed in the doctor’s office. Using ultrasound guidance, a fine needle is passed into the perforating vein through the skin. The radiofrequency current heats the inside of the perforator causing it to shrink down and remove the abnormal flow between the deep and varicose veins. Treatment itself takes approximately 10 minutes per perforating vein. Some patients have one perforator vein or multiple veins on the same leg that require treatment. You can expect to be in the office for at least an hour, because of the sterile preparation and set-up portion of the procedure.
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.
What are the possible adverse effects?
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®).

Expect some bruising over the injection sites, which fades over about two weeks.

Less common complications include blood clots within the deep veins or a temporary area of skin numbness over a tiny branch of a skin nerve that travels close to a vein.

VARITHENA® CHEMICAL ABLATION

illustration of varithena foam injection
Varithena® may be recommended based on your vein location, size, anatomy and vein tortuosity.
Varithena® is:
• Effective to treat veins of different sizes above and below the knee
• Requires no incisions, sedation or general anesthesia
• Does not require a wire to be inserted along the length of your vein
• Does not use heat, eliminating the risk of thermal injury
WHAT IS VARITHENA®?
Varithena® is a "microfoam" formulation of polidocanol (sclerosing agent) and CO2. The result is a microfoam that has an appearance and consistency similar to white, foamy shave cream.
Ultrasound guidance is used to inject Varithena® microfoam into the vein. The microfoam fills the lumen for circumferential contact where it's designed to displace blood and destroy the endothelial lining efficiently.
cross section of Illustration of a vein with foam sclerotherapy injection
Video below shows the proceedure.
How many treatments will I need?
The number and frequency of treatments depends on a patient's anatomy, how quickly the veins respond, and the patient's treatment goals. There is a limit on the amount of medication we can give you each day to avoid causing side effects. Some larger or resistant veins may require two treatments to respond completely but most veins respond to Varithena® after one treatment.
What should I expect on my treatment days?
You will sign your consent form then change into shorts provided by the office. We will clean your skin with alcohol, then use ultrasound to localize the veins. The foam medication will then be injected into your veins with a fine needle. The foam fills and treats the desired section of the vein. The diseased vein collapses and the foam is deactivated. Your legs will be elevated on a comfortable wedge pillow for approximately 15 minutes. After your treatment, we will help you into your compression stockings, then you will walk for 30 minutes prior to getting in your car.

ULTRASOUND GUIDED FOAM SCLEROTHERAPY

Treats Surface Varicose Veins
Ultrasound guided foam sclerotherapy works well for treating surface varicose veins and veins that are not visible to the naked eye. The foam medication can be seen on ultrasound, which allows us to administer it precisely and direct it towards nearby varicose veins. Foam sclerotherapy can be safely used for veins that travel close to the skin or nerves. It also travels easily through veins with many twists and turns.
WHAT IS POLIDOCANOL (ASCLERA®)?
A variety of sclerosant medications can be used for veins, but we prefer polidocanol (brand name Asclera®) because it is the most comfortable for the patient and has the lowest risk of side effects. It is a detergent-type medication that injures the inner lining of the veins. This causes the vein to stop flowing, then eventually close down completely. Polidocanol has been well-studied and has been approved by the FDA since 2010 for the treatment of varicose veins and has been used in Europe for decades. Polidocanol is turned into a foam to treat larger veins. This is an off-label use of the sclerosant but very effective and well tolerated. La Jolla Vein Care providers have extensive experience with foam sclerotherapy.
Read our Patient Handout
Video below shows the proceedure.
How many treatments will I need?
The number and frequency of treatments depends on a patient’s anatomy, how well the veins respond to each treatment, and the patient’s treatment goals. The national average is 2 to 5 treatment sessions to achieve 80% improvement. Some larger or resistant veins require two or more treatments to respond completely.
What should I expect on my treatment days?
You will sign your consent form then change into shorts provided by the office. We will clean your skin with alcohol, then use ultrasound to localize the veins. The foam medication will then be injected into your veins with a fine needle. You will elevate your legs on a wedge pillow for approximately 15 minutes. After your treatment, we will help you into your compression stockings, then you will walk for 30 minutes prior to getting in your car. It is normal for your legs to be achy and tender to the touch after treatment.

VenaSeal™ closure system permanently treat varicose veins by sealing the affected superficial veins using an adhesive agent.

The VenaSeal™ Sapheon Closure System
HOW DOES THE TREATMENT WORK?
VenaSeal™ is a unique, minimally invasive treatment that uses a safe-for-the-body medical glue to quickly and effectively treat varicose veins (venous reflux disease). Using ultrasound, a doctor will guide a tiny catheter through a small access site in the skin and into the diseased area of the vein. Next, the VenaSeal™ dispenser delivers a very small amount of medical glue to close the vein. Once the affected vein is closed, blood is immediately re-routed through other healthy veins in the leg.
Unlike other treatments, VenaSeal™ does not require anesthesia to be injected into the leg via multiple needle sticks (tumescent anesthesia), and because there are no pre-procedures drugs involved, patients can return to their normal activities right after the treatment. Unlike heat-based procedures, with VenaSeal™ there is no risk of skin burns or nerve damage. VenaSeal™ usually does not require any post-treatment pain medication or uncomfortable compression stockings.’
Video below shows the proceedure.
The VenaSeal™ closure system is the only non-tumescent, non-thermal, non-sclerosant procedure that uses a proprietary medical adhesive delivered endovenously to close the vein. This unique approach eliminates the risk of nerve injury when treating the small saphenous vein, which is a risk sometimes associated with certain thermal-based procedures. Clinical studies have demonstrated that the procedure is safe and effective.

Call La Jolla Vein Care at 858-550-0330 to find out if VenaSeal™ is a good option for your vein treatment!
Read our Patient Handout

MECHANICAL-CHEMICAL ABLATION (CLARIVEIN®)

The ClariVein® procedure
for treatment of backwards flow (or “reflux”) in your saphenous vein(s). The great and small saphenous veins are the two main superficial veins of the leg. They run along the inner leg and the back of the leg, respectively.

This minimally invasive procedure can be performed in the office in less than an hour and patients return to their usual level of activity the same day.
HOW DOES THE TREATMENT WORK?
The skin is numbed with lidocaine, then the ClariVein® catheter is placed into the unhealthy vein. The catheter closes the vein painlessly by delivering two treatments:
1. Mechanical treatment with a tiny rotating wire.
2 .Chemical treatment with polidocanol. Polidocanol is a detergent-type sclerosant medication that is commonly used in varicose vein treatment.

This technique is highly effective in closing the vein and only requires one skin puncture, similar to placing an IV.
Read our Patient Handout
Clarivein After Care Instructions
Video below shows the proceedure.
How many treatments will I need?
The number and frequency of treatments depends on a patient’s anatomy, how well the veins respond to each treatment, and the patient’s treatment goals. The national average is 2 to 5 treatment sessions to achieve 80% improvement. Some larger or resistant veins require two or more treatments to respond completely.
What should I expect on my treatment days?
In the video below Dr. Bunke discusses the ClariVein® proceedure.


CONSERVATIVE MANAGEMENT AND SELF-CARE FOR VARICOSE VEINS

CONSERVATIVE MANAGEMENT
Conservative management and lifestyle changes can ease the symptoms of varicose veins 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. Conservative options include:
Compression stockings:
These elastic stockings squeeze or compress the veins to help circulate blood. The compression stockings prevent blood from flowing backward and pooling in the legs. 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. Compression stockings come in different strengths and the most common strength for the treatment of varicose veins is 20-30mmhg. Your doctor should advise you which strength of compression stockings you should wear. In patients with peripheral arterial disease (PAD), diabetics, and neuropathies, compression may be contraindicated or lesser strengths of compression may be advised
Read our Patient Handout
Avoid inactivity
Standing or sitting for long periods of time can aggravate your vein condition.  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.
Dietary Supplements
Supplements such as horse chestnut and grape seed extract can help reduce symptoms of venous disease. Vasculera 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
Dietary Changes and High Fiber Diet
A flavinoid rich diet including berries, green teas can reduce inflammation and pain. A high fiber diet can increase abdominal pressure and may be helpful for varicose veins. Make sure to drink plenty of water with your high fiber diet.
Anti-inflammatory Medications
are helpful to reduce pain and inflammation, but check with your doctor first to make sure you don’t’ have contraindications to using them. Ibupfren and Advil are common oral anti-inflammatory medications. There are also anti-inflammatory cream or gels that can be applied topically to the painful veins, such as Voltaren gel.
Ice Packs
and heating pads can be applied to tender veins.    Ice packs and heating pads can be used in an alternating manner.
Weight loss
or maintaining a healthy weight: Being overweight puts extra pressure on your veins.