18, 10, 2022

What you need to know about Varithena




Foam Sclerotherapy

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.

Varithena (polidocanol injectable foam)

is a prescription medication used to treat the great saphenous vein system (GSV) and associated varicose veins of the GSV system. Varithena® improves the symptoms of superficial venous incompetence and the appearance of visible varicosities. It is a non-thermal, non-tumescent, nearly painless method of vein treatment. 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

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 the day of treatment?

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.

“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. 



What you need to know about Varithena2022-09-19T18:19:50-07:00

9, 8, 2022

Swelling & Varicose Veins


Complications of Untreated Varicose Veins and Venous Insufficiency: Swelling of the Ankles/legs


Leg swelling (swelling is also known as edema), is a common complaint related to varicose veins and underlying venous insufficiency. Leg swelling 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. 


The 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.


This usually usually affects the ankles. Most people with vein-related 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.) Vein-related swelling is worse at the end of the day, with prolonged standing, sitting or with air travel, heat and menstruation. The degree of swelling varies from one person to another.


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.


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 swelling.


For more information check out our website resources and to book a consultation, please give our office a call at 858-550-0330. 

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


Swelling & Varicose Veins2022-07-19T17:52:04-07:00

Cellulitis & Varicose Veins


Complications of Untreated Varicose Veins and Venous Insufficiency: Cellulitis

Cellulitis is a bacterial infection of the skin and tissues beneath the skin. Cellulitis infections can occur in the legs of people with untreated varicose veins and chronic venous insufficiency.  The reason for this is chronic venous insufficiency-which causes inflammation within the skin and underlying tissues. This inflammatory process causes the skin to become firm, eczema-like, dry, itchy, and fragile. Healthy skin acts as a barrier to bacteria, preventing infections. But, in chronic venous insufficiency, the skin is fragile and this barrier is susceptible to bacterial infections that can enter the tissues through cracks or breakages within the skin.  In chronic venous insufficiency, the skin around the ankles is most affected and infections can begin here.

Cellulitis usually begins as a small area of pain and redness on the skin. This area spreads to surrounding tissues, resulting in the typical signs of inflammation such as redness, swelling, warmth, and pain. Fever and chills may develop and the redness will spread affecting more of the leg. It is treated with antibiotics. If you believe you have signs of cellulitis, you need to contact your doctor right away as untreated cellulitis can spread rapidly.

This complication can be avoided by treating the varicose veins and eliminating underlying venous insufficiency, which will, in turn, reduce inflammation and improve the skin condition. 

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

Practicing good skin hygiene is important. Keep your skin moisturized so that it doesn’t flake or crack easily. If the skin is not broken or leaking fluid but is inflamed, your doctor may recommend an anti-itch cream, such as one containing hydrocortisone; a cream containing zinc oxide to protect the skin; or an antifungal cream to prevent fungal infections.

Skin that is leaking fluid is treated with wet compresses. If you have ulcers on your legs, we at La Jolla Vein & Vascular will show you how to apply layered compression bandages to protect the skin and maintain blood flow.

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

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

Cellulitis & Varicose Veins2022-07-19T17:21:50-07:00

What you need to know about Sclerotherapy procedure


Today, sclerotherapy is clearly the gold standard for removing spider and varicose veins. During this procedure, a specially trained physician injects a safe sclerosing agent directly into the blood vessel. The effectiveness of the procedure comes as a direct result of the training, experience, and judgment of the physician to make sure that the sclerosant’s volume, concentration, and exposure time are exactly right. 


What happens next? The solution displaces the blood in the vein, causing it to immediately appear lighter in color. The solution irritates the vein lining, causing it to collapse and blocking it from receiving more blood. Within a few weeks, the unused vein is absorbed by the body and disappears. With advancements in medicine, there’s no reason to go under the knife anymore—sclerotherapy is a safe, effective, and cost effective alternative to surgery.


Sclerotherapy Treatment for Spider Veins

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 newer solutions such as AscleraTM allow for spider veins to be treated with minimal discomfort and immediate return to activities. Vein specialists rarely use saline solutions these days, because alternative solutions are less painful and better tolerated. Sclerotherapy is preferred by most vein specialists over laser because spider veins often have underlying ‘feeder veins’ that can easily be treated with sclerotherapy, but are not addressed by laser. Many people will require more than one treatment session for optimal results. The national average is 2 to 5 treatment sessions. Treatment sessions are often spaced a month apart, but your health care provider will help determine your customized care plan. Wearing compression stockings after treatment will improve results.

For larger veins, the medication may be turned into a foam, this is referred to as foam sclerotherapy. Foam sclerotherapy is similar to sclerotherapy of spider veins but instead of a liquid solution, a foamed-solution is injected directly into the vein via a small needle. The solution can be seen on ultrasound monitoring which allows it to be directed into nearby varicose veins painlessly. The veins will seal shut, and gradually be broken down by the body.

Below are a few patient cases after Sclerotherapy Treatment which you will see the before and after results. 


If you experience any vein disease symptoms, please call our office at (858)-434-5998 to schedule a consultation with one of our knowledgeable doctors at La Jolla Vein and Vascular. 


For more information on vein health please check out our Youtube Channel or visit our helpful guide of resources. 


What you need to know about Sclerotherapy procedure2022-07-16T18:32:09-07:00

26, 7, 2022

Do varicose veins cause leg cramps?


Leg cramps occurring at night (nocturnal leg cramps) are a common symptom of venous disease. In fact, in the San Diego Population Study, leg cramps were the second most common symptom in people with the venous disease with a prevalence of 14.3%. Leg aching (17.7%) was the most common complaint and tired and swollen legs were also predominant symptoms.

Healthy veins collect the deoxygenated blood from the tissues. The venous blood, which is low in oxygen and high in waste products is returned to the heart and lungs where it is replenished with oxygen and nutrients.  In diseased veins, the blood circulates poorly, allowing blood to pool and become stagnant. The exact mechanism that causes cramping in the legs is uncertain.  But, when the cramping is caused by poorly functioning veins, the symptoms are often alleviated by correcting the underlying problem.  Conservative measures, such as elevating the legs, walking regularly, and wearing compression therapy may reduce the frequency of night cramps. Treating the underlying venous insufficiency may be curative.

There are many causes for leg cramps and if you suffer from night cramps it is important to be properly evaluated to determine the cause.  Cramps that occur with exercise are more likely to be associated with a more serious condition. If your muscles cramp with walking for a short time and recover with rest this may indicate arterial disease.  Other causes for leg cramps include muscle injury, thyroid conditions, pregnancy, electrolyte imbalance, dehydration or other causes.

To help identify the cause, it may be helpful to keep a log of daily activities, or change in activities; for example, heavy exertion may indicate a muscular cause or long periods of standing or sitting may favor the venous disease.  A recent study showed that prolonged standing at work may be an important risk factor for varicose veins and nocturnal leg cramps.

Check with your primary care physician to rule out other causes for leg cramps. Blood tests can check for thyroid, kidney and electrolyte conditions.  You may also have undiagnosed venous reflux.

At La Jolla Vein Care, our vascular imaging scanners help us detect vascular causes of leg pain. For example, we can utilize one of our three duplex ultrasound imaging systems to scan for blood clots in the leg veins (deep venous thrombosis), venous insufficiency and identify significant problems in the arterial circulation.


If you experience any vein disease symptoms, please call our office at (858)-434-5998 to schedule a consultation with one of our knowledgeable doctors at La Jolla Vein and Vascular. 


For more information on vein health please check out our Youtube Channel or visit our helpful guide of resources


Do varicose veins cause leg cramps?2022-06-25T18:22:43-07:00

29, 6, 2022

Why Choose Genicular Artery Embolization (GAE )?


Why Choose Genicular Artery Embolization (GAE )?


It is essential to point out that while Genicular artery embolization (GAE). It is a relatively new procedure for treating osteoarthritis (OA). It is more effective than other treatments. One of the main reasons you should choose Genicular artery embolization (GAE) is that it is minimally invasive. The procedure is performed by an outpatient surgeon, allowing you to go back home the same day. Research also shows that the procedure has low risk and much faster recovery. Unlike taking drugs with numerous side effects, such as stomach upsets, the procedure has minimal side effects. Additionally, the procedure has a very high success rate, with eighty-five percent of patients treated with Genicular artery embolization (GAE) reporting significant pain and discomfort relief within the first month.


Genicular Artery Embolization (GAE) vs. Surgery


Compared to traditional surgeries performed to treat knee osteoarthritis, Genicular artery embolization (GAE) is more efficient and safe. This procedure is minimally invasive for starters, meaning that it requires a small incision in the skin. The scar is barely visible 1-2 months after the procedure. No one loves having scars on their feet. Unfortunately, extensive knee surgeries such as complete knee replacement leave large scars that are difficult to conceal.


Secondly, you get to go home the same day. Knee surgeries require the use of general/local anesthesia, which takes time to wear off. You will also need to spend a night or two for doctor observation after surgery. With Genicular artery embolization (GAE), you do not need to spend the night in the medical facility. Additionally, the procedure works for everyone, including people at high risk of complications and would not want to undergo expensive knee surgeries.


Why Choose La Jolla Vein & Vascular?


As mentioned, osteoarthritis affects almost 30 million people in the United States alone, with the knee being the most affected body part. The largest portion of these individuals is not quite ready for knee replacement surgery. As such, most of these patients depend on NSAIDS and knee injections to control the pain.

Unfortunately, over 100,000 people are hospitalized each year for gastrointestinal bleeding and other NSAIDs related complications. Even worse, there are more than 20,000 NSAID deaths annually. At LA Jolla Vein Care, we are one of the few medical facilities that offer Genicular artery embolization. The procedure is safe and effective for everyone.

With so many medical clinics cropping up here and there, we understand that choosing a health facility where you can entrust to perform new and advanced procedures such as Genicular artery embolization (GAE) is not easy. 


However, our results speak for themselves. Our licensed surgeon has performed numerous successful GAE procedures for our patients. Call us today and schedule your appointment!  We also schedule follow-up appointments to assess your progress.  Our friendly staff is also ready to assist you with questions and concerns that you may have.


Why Choose Genicular Artery Embolization (GAE )?2022-05-23T16:37:49-07:00

What is Stenting



Stenting is a procedure that is performed in combination with Angioplasty and atherectomy.

At La Jolla Vein & vascular, we are dedicated to offering our patients various procedures and treatment options. One of those options is called an Angioplasty. It is also called percutaneous transluminal Angioplasty (PTA), Angioplasty is a medical procedure performed using a catheter. A catheter is usually a thin, flexible tube inserted through an artery and guided by imaging to the narrowed section of the artery. Once the tip of the catheter reaches the narrowed section, the small balloon at the end inflates for a short period. The pressure created by the inflated balloon usually presses the plaque against the artery wall. This procedure will help to widen the arteries, restoring normal blood flow. Stenting is done in combination with an angioplasty. 


Years of plaque buildup damages the artery walls. Even after cleaning the artery, the walls are often too weak to stay open. Stenting is a procedure that helps support the blood vessel walls, preventing them from closing after removing the plaque. The procedure involved placing a small mesh tube inside the artery to offer rigid support.

La Jolla Vein & Vascular offers renal artery stenting, which helps support the blood vessels that transport the blood to your kidneys. A patient with a history of arterial disease or who suffers from hypertension has a higher risk of plaque building up in the renal artery wall. Excess plaque on the renal artery tends to weaken the walls. Renal artery stenting offers firm support that ensures the blood flows unobstructed to the kidney.

 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.


What is Stenting2022-05-23T16:16:54-07:00

Why Choose Prostate Artery Embolization (PAE)


Prostate Artery Embolization (PAE)


Prostate Artery Embolization (PAE) is a relatively new and safer outpatient procedure performed by interventional radiologists to help treat benign prostatic hyperplasia (BPH), commonly known as enlarged prostate. While an enlarged prostate might not be life-threatening, it may affect your daily activities. PAE has a high success rate than various treatments available for BPH, with over ninety percent of the men experiencing significant relief in the first year. Additionally, PAE does not cause unwanted sexual side effects common with other treatments for Benign Prostatic Hyperplasia (BPH). Before looking at the other numerous benefits of the PAE procedure, let’s start by understanding exactly what BPH is and how it can affect a man’s daily life.


How is the Procedure Performed?


Your surgeon will make a small incision in the groin and insert a catheter through the artery that supplies blood to the prostate. After inserting the catheter, the surgeon injects a solution that contains thousands of microscopic plastic beads. Should change to “The tiny beads block the artery that supplies blood to the prostate. The process is referred to as embolization. Your surgeon will repeat the procedure on the other side but from the original incision. Depending on the location and the size of the prostatic arteries, the PAE procedure takes anywhere from 1 to 4 hours.


By blocking the blood flow of blood to the area affected by BPH, the cells in the prostate start to die. Over a few months, the immune system reabsorbs the dead tissues and forms a scar. The scar tissue gradually contracts, shrinking the prostate. The prostate usually shrinks by about 20 to 40 percent in about six months, resulting in significant symptom improvement and increased urine flow. Since it is impossible to block the blood flow to the prostate, partial blockage of blood flow also leads to a necrosis process that makes the prostate softer, alleviating the pressure that causes urine blockage.


After the PAE Procedure


Unlike surgeries, PAE does not involve the use of general anesthesia. However, the patient will get IV medication that takes the anxiety and pain, making you more comfortable during the procedure. The procedure is not painful and takes less time when compared to other surgeries.Since the procedure does not involve removal of the prostate part physically, you may not see the results immediately. However, the patient will start noticing significant results in 1-2 months and continue getting consistently better results until 5-6 months later.


Why Choose Prostate Artery Embolization (PAE)2022-05-23T16:03:46-07:00

Pros and Cons of Pelvic Vein/Ovarian Embolization Procedure:


Pros and Cons of Pelvic Vein/Ovarian Embolization Procedure:



  • Pelvic Vein Embolization of the ovarian vein or pelvic vein has already been demonstrated to be a safe procedure for relieving pain sensations and improving varicose vein appearance.
  • Embolization helps shut off affected veins, easing pressure from them, so they reduce in size.
  • It’s a minimally invasive technique requiring only a tiny incision in the skin. You won’t even need stitches.
  • Fewer complications than traditional surgery. You also lose less blood, and the incision mark is not even visible. You won’t also need to stay in the hospital for long.
  • 85 % of women who undergo the procedure report feeling much better within 14 days of the operation

Pelvic Vein Embolization Risks

  • You may be allergic to the iodine-based dye and a contrast agent used to take detailed images.
  • A small number of women develop infections after embolization.
  • Since the procedure involves placing a tube inside blood vessels, it may damage them or cause bruising and bleeding at the point of incision.
  • if an embolic agent migrates to the wrong place, it may cut off the oxygen supply to the tissue, i.e., non-target embolism
  • There’s a 10 % chance that the varices may develop in the veins again.
  • It exposes the ovaries to radiation. However, studies have not found any links between the procedure and infertility or abnormal periods.



How to Prepare for Pelvic Vein Embolization?


We offer treatment for Pelvic Vein Embolization at La Jolla Vein & Vascular. The doctor will monitor your blood pressure and heart rate. Some patients suffer slight pain or discomfort following the surgery, which can be managed with simple medications taken by mouth or intravenously through the cannula.

Bed rest is advisable for a short period after the procedure. Most patients are cleared to leave the hospital after 4 hours. However, if you’re in significant pain, you might want to stay for longer and get extra care.

Once discharged, expect to resume your normal activities within a few days; however, don’t drive within the first week following the procedure. Of course, you can wait for longer in case of groin discomfort and get medical care too.

After your operation or therapy, your doctor may urge a follow-up scan and checkup. This is to determine whether the operation was successful and address any changes or adverse effects you may have noticed following the treatment. Just like other varicose veins on the leg, engorged veins in the thigh, vulva, buttocks, etc., may need to be treated separately.

The enlarged veins should gradually reduce in size within a few weeks by preventing reflux in pelvic veins. Even the vulvar varicose veins should disappear. You can also seek treatment for any varices in the lower legs. Various safe treatment options can be used to rid of the condition for good. However, seek treatment for other vein varices only after dealing with pelvic vein varices to reduce the chances of the condition coming back in the future. After pelvic vein embolization treatment, any symptoms you’ve been experiencing due to the veins,  should go away.

  1. You will need to have your warfarin medication altered if you are taking any before the pelvic vein embolization. Consult with a doctor for details.
  2. Keep a list of your medications, even the herbal ones, and inform your doctor of any allergies, including allergic to the iodine dye.
  3. Inform your doctor of any recent medical issues, illnesses, or if you are pregnant. Pelvic venography and vein embolism involve the use of X-rays; you don’t want the fetus exposed to the radiation.
  4. Pack comfortable clothes; you will also be given a gown at the hospital for use during the procedure.
Pros and Cons of Pelvic Vein/Ovarian Embolization Procedure:2022-05-23T15:56:36-07:00

Arterial Treatments


Arterial Treatments


Peripheral Arterial Disease – Treatment

Arterial treatments for the peripheral arterial disease (PAD) has two main goals. One is to manage the symptoms, including leg pain, allowing you to resume your normal physical activities. The second one is to top the progression of atherosclerosis in the body, which reduces the risk of stroke and heart attack.

The good news is that through early intervention, you can achieve these goals through lifestyle changes. Quitting smoking is one of the most significant things you can do to stop the progression of Pad. Walking and exercising regularly following supervised exercise training can improve your symptoms. However, if your peripheral artery disease is at an advanced stage, you will need additional medical treatment. Here are some of the standard peripheral artery disease treatment options available.


A lower extremity atherectomy is a minimally invasive surgical procedure involving a catheter to remove plaque from arteries. The doctor usually makes a small incision in the artery to insert the catheter. The procedure is performed under local anesthesia to prevent pain. A catheter collects removed plaque in a chamber placed at its tip, ensuring that all the particles are removed from the artery. Depending on the amount of plaque in your arteries, your doctor will repeat the procedure several times to ensure optimal blood flow.

Why Do I Need This Procedure?

The primary goal for the atherectomy is to eliminate plaque buildup in the artery. You may need this procedure when your arteries become too narrowed or blocked due to increased plaque. When the arteries are blocked, blood flow is restricted, meaning that your tissues will not have sufficient oxygen and nourishment they need to survive. Insufficient blood flow causes the muscle in your feet to cramp and lose strength. The procedure is not ideal for all people. Before performing the procedure, the doctors customize to meet the patient’s unique needs. 

Where is the Procedure Performed?

We usually perform the procedure in our facility. Our board of certified doctors have undergone rigorous training to ensure the best possible results. We also have a state-of-the-art facility with modern atherectomy tools that ensure success even for complex conditions. Our doctors also have a vast wealth of experience in this field. Having performed thousands of atherectomy procedures is sure that you are in the right hands. 

How do I Prepare for an Atherectomy?

A few days before the procedure, the doctor usually performs a pre-procedure test to ensure that it is safe for you to undergo the procedure. The doctor may recommend discontinuation of using certain medications days before the procedure. Our healthcare team will also provide you with specific instructions to prepare for the procedure.


Arterial Treatments2022-05-23T14:56:03-07:00
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