8, 9, 2023

Understanding what vein disease is and is not

2023-08-29T18:44:36-07:00

Understanding what vein disease is and is not

Venous reflux disease, alternatively referred to as venous stasis, venous insufficiency, or venous incompetence, is a complex condition affecting the veins of the legs. In this article, we will delve into the details of venous reflux disease, from its causes and symptoms to the progressive nature of the condition. We’ll also explore the crucial role of ultrasound technology in diagnosing and formulating personalized treatment plans.

Understanding Venous Reflux

At the heart of venous reflux disease lies the concept of ‘leaky valves’ within the leg veins. These valves, responsible for maintaining proper blood flow, may fail, causing blood to flow backward (reflux) instead of towards the heart. Venous reflux can occur in both deep and superficial leg veins, affecting the efficiency of blood circulation.

The Anatomy of Reflux

In the leg veins, there are two main types: deep and superficial. The deep veins, residing within the muscle, carry the majority of blood from the legs back to the heart. On the other hand, superficial veins are situated outside the muscle, just beneath the skin. Key players in the realm of superficial veins are the Great Saphenous Vein (GSV), coursing through the thigh and calf, and the small saphenous vein, running along the back of the calf.

Impact of Leaky Valves

Ordinarily, one-way valves in leg veins facilitate blood flow against gravity, aided by the contraction of calf muscles. When these valves become leaky, blood flows backward, leading to blood pooling in the lower legs. This condition manifests in symptoms such as leg heaviness, pain, fatigue, ankle swelling, and even restless legs at night. Over time, venous reflux disease can progress, giving rise to skin changes, including darkening, dryness, itching, and the potential development of venous leg ulcers.

Diagnosis through Ultrasound

Diagnosing venous reflux disease requires specialized tools, with ultrasound technology leading the way. Not all vein issues are visible to the naked eye, as many arise from veins beneath the skin’s surface. Ultrasound examinations provide insights into the direction of blood flow, valve functionality, and the presence of blockages or scars in the veins.

Personalized Treatment Steps

Addressing venous reflux disease involves a strategic approach tailored to each patient’s unique condition. The treatment process typically consists of three key steps:

Step 1: Treating Underlying Reflux
The initial focus is on addressing the root cause—venous reflux. This is achieved by targeting the saphenous veins, which are often the origin of the issue. Innovative vein ablation procedures like radiofrequency ablation, laser ablation, mechanico-chemical ablation (MOCA), and Varithena Foam are employed to restore proper blood flow.

vein disease

Step 2: Tackling Varicose Veins
Once underlying reflux is resolved, attention shifts to varicose veins. Foam sclerotherapy, involving injections of a foamed medication, or minimally invasive removal methods, can be employed to eliminate bulging veins.

vein disease

Step 3: Managing Spider Veins
For those seeking cosmetic enhancement, spider vein treatment through sclerotherapy is available. Although cosmetic in nature, this step completes the comprehensive treatment journey.

vein disease

Venous reflux disease is a multifaceted condition that requires specialized care for effective management. Our approach encompasses state-of-the-art diagnostics, cutting-edge treatments, and personalized care to address the various aspects of this condition. Through our expertise and commitment, we aim to provide transformative outcomes, enhancing both the health and quality of life of our patients. If you’re ready to embark on the journey to healthier veins, contact us to take the first step towards comprehensive vein and vascular wellness.

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Amanda Steinberger, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

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

 For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link, and our website https://ljvascular.com

For more information on varicose veins and eliminating underlying venous insufficiency,

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 

For more blogs and educational content, please check out our clinic’s blog posts! 



Understanding what vein disease is and is not2023-08-29T18:44:36-07:00

9, 5, 2023

Venous reflux disease 101

2023-02-15T19:01:31-08:00

In addition to your physical exam findings and medical history, an ultrasound examination is an important tool in the assessment of venous disease. Not all venous disease is visible to the naked eye, and it usually arises from veins that are beneath the surface of the skin, only visible by ultrasound technology.

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.

Below are some photographs from our ultrasound exams. Take a peak for an inside look on what to expect during your ultrasound appointment. 

venousvenous11reflux

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

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

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 


Venous reflux disease 1012023-02-15T19:01:31-08:00

22, 2, 2023

Patient Reviews & Testimonials

2023-01-14T13:33:37-08:00

La Jolla Vein & Vascular is a state-of-the-art medical center dedicated exclusively to the diagnosis and treatment of venous and arterial conditions.

Venous conditions include varicose veins, spider veins, and venous leg ulcers, chronic venous insufficiency, edema, lymphedema, and deep vein thrombosis.  Arterial conditions and treatments such as peripheral arterial disease (PAD), atherectomy, angioplasty, stenting.  We also offer prostate artery embolization (PAE) to treat BPH, varicocele embolization for men and uterine fibroid embolization (UFE), pelvic venous congestion (PVCS), pelvic and labial varicose veins for women.  Osteoarthritis treatment includes genicular artery embolization (GAE) to alleviate knee pain due to arthritis.

Below are some patient reviews and testimonials. 

venous 12 3 13 1 14

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

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

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 

Patient Reviews & Testimonials2023-01-14T13:33:37-08:00

Patient Reviews and Testimonials

2023-01-14T13:22:24-08:00

La Jolla Vein & Vascular is a state-of-the-art medical center dedicated exclusively to the diagnosis and treatment of venous and arterial conditions.

Venous conditions include varicose veins, spider veins, and venous leg ulcers, chronic venous insufficiency, edema, lymphedema, and deep vein thrombosis.  Arterial conditions and treatments such as peripheral arterial disease (PAD), atherectomy, angioplasty, stenting.  We also offer prostate artery embolization (PAE) to treat BPH, varicocele embolization for men and uterine fibroid embolization (UFE), pelvic venous congestion (PVCS), pelvic and labial varicose veins for women.  Osteoarthritis treatment includes genicular artery embolization (GAE) to alleviate knee pain due to arthritis.

Below are some patient reviews and testimonials. 

venous 10 1 11 2 12 2

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

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

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 



Patient Reviews and Testimonials2023-01-14T13:22:24-08:00

17, 1, 2023

Patient Transformations from venous disease: varicose veins

2023-01-14T12:52:41-08:00

What are varicose veins (venous disease)?

Varicose veins (venous disease) are the twisted, bulging veins just beneath the surface of the skin. Varicose veins 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. Varicose veins are a common condition.

What causes varicose veins?

Varicose veins are caused by leaky vein valves, which allow blood to pool within the veins causing them to stretch and become enlarged. Varicose veins 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.

In our study, led by Dr. Nisha Bunke and published in the Journal of Vascular Ultrasound in 2018, we studied over 1,000 legs with varicose veins. Over 90% of the time, the source of the varicose veins were the great and small saphenous veins. The Great Saphenous Vein (GSV) courses up the middle of the thigh and calf and the small saphenous vein (SSV), which courses along 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. 

La Jolla Vein & Vascular Before and After Transformations:

venousvenousvenous

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

“Bringing Experts Together for Unparalleled Venous and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

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

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 

Patient Transformations from venous disease: varicose veins2023-01-14T12:52:41-08:00

28, 11, 2022

What you need to know about venous insufficiency

2022-10-24T11:36:50-07:00

When you become a patient with La Jolla Vein and Vascular, you will go through a screening process, and a vascular evaluation using ultrasound technology to diagnose your venous reflux disease. Chronic venous insufficiency is a disease affecting at least 50 million Americans. It is very common, but unfortunately undiagnosed. Through our venous insufficiency Duplex Ultrasound test, our vein specialists can determine exactly what is going on in the patient’s veins. 

The anatomy and process of venous insufficiency or venous reflux disease: 

One of the major veins that takes the blood to the heart is deep inside the muscles of the thigh and calf called the deep veins. Parallel to this lies the superficial veins inside the legs. Superficial veins dump the blood into the deep vein in the groin area and collectively they take the blood back to the heart. 

The direction of the blood flow begins from the ground up towards the heart. Both deep and superficial have a structure system known as the valves. They function as a safety unit directional valve system. Where the blood can flow upward and not downward and be open or closed off. Similarly the same type of structure is found in your heart with heart valves. 

Over the course of the years, depending on your occupation, family history, pregnancy, surgeries, any trauma or injury to your legs, and any kind of underlying muscular or skeletal problem will contribute to problems with the valves in your legs. The valves, over the course of the years may get farther apart from one another. They will still be able to open and close, but the main problem will be the blood flow will not be able to go in one direction. This causes the veins to become enlarged. As a result,  the valves remain open and the blood to flow upward and also downward. This is known as venous reflux disease or venous insufficiency. 

A consultation with one of our vein specialists for chronic venous insufficiency involves taking a detailed history and physical examination in combination with a venous reflux ultrasound study.  Based on your personal findings, a customized treatment plan will be discussed which may include doing nothing, conservative management, or various treatment options based on your individual needs. 

 

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

 

Our accredited center is also a nationally known teaching site and center of excellence. 

 

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

 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

 

What you need to know about venous insufficiency2022-10-24T11:36:50-07:00

31, 8, 2022

Skin Darkening and Varicose Veins

2022-07-20T16:21:50-07:00

Untreated varicose veins and underlying venous insufficiency can cause changes in the skin, including skin darkening. We call this skin hyperpigmentation.  This usually occurs in the inner ankle and can worsen to involve the lower portion of the leg as shown in the picture.  Over time, the skin becomes firm, dry, eczema-like, and can even break open, causing a venous leg ulcer. When the skin becomes darker as a result of a vein problem, this is referred to as chronic venous insufficiency (CVI). This can be prevented by addressing the underlying venous insufficiency and varicose veins early on. 

 

What is chronic venous insufficiency?

Chronic venous insufficiency (CVI) is an inflammatory condition caused by long standing, untreated venous reflux disease.  Commonly, venous reflux disease causes a collection of symptoms such as leg swelling, heaviness, fatigue and varicose veins. But, over time, when blood is no longer circulating properly in the leg veins, skin changes can also appear. When skin changes appear, this is termed, chronic venous insufficiency (CVI). Venous stasis is another term used for this condition.   Chronic inflammation from CVI causes the skin around the ankles to darken, become dry, itchy, and firm. In severe cases, the skin can start to break down and ulcerate. The ulcer (wound) occurs in the inner or outer ankle and is also referred to as a stasis ulcer or venous ulcer.

Venous stasis skin changes associated with venous insufficiency include:

  • Darkening of the skin along the ankles
  • Itching and dry skin around the ankles (venous eczema)
  • Development of wounds around the ankles, called venous leg ulcers

How La Jolla Vein & Vascular treats patients who experience darkening of the skin:

 

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 within 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 Veins

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.

 

Skin Darkening and Varicose Veins2022-07-20T16:21:50-07:00

18, 11, 2014

Highlights of the National Vein Congress

2014-11-18T18:27:49-08:00

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.

 

 

 

Highlights of the National Vein Congress2014-11-18T18:27:49-08:00
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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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