25, 11, 2022

What you need to know about abdominal aortic aneurysm

2022-10-24T14:50:55-07:00

What is an abdominal aortic aneurysm (AAA)?

The aorta, the largest artery in your body, runs from your heart, down through your chest, and into your abdomen. The abdominal region of the aorta is responsible for delivering blood to your legs, GI tract and kidneys.

An abdominal aortic aneurysm (AAA) occurs when the wall of the aorta progressively weakens and begins to bulge. An AAA may continue to enlarge and eventually rupture if left untreated, causing severe internal bleeding and possibly death. Nearly 200,000 people in the United States are diagnosed with A A A annually; approximately 15,000 die each year from a ruptured AAA.

In addition to concerns about rupture, clots or debris may also develop within an AAA. These substances can be carried to other areas in the body and block circulation, causing severe pain or possibly limb loss if blood flow is cut off for too long.

AAA can be safely treated with early diagnosis; however, most patients have no symptoms.

Causes and Risk Factors:

Most aortic aneurysms are caused by a breakdown in the proteins that provide structural strength to the wall of the aorta. Some risk factors that contribute to this structural breakdown include:

  • Age—individuals over 60 years are most likely to develop the condition
  • Gender—males are more prone to the condition than females
  • History of atherosclerosis (hardening of the arteries) • Family history of AAA
  • Smoking
  • High blood pressure

Symptoms:

Most people feel no symptoms, and an abdominal aortic aneurysm is often detected when tests are conducted for other unrelated reasons. Those who do have symptoms commonly describe back pain, pulsations in the abdomen, groin pain or sometimes sores on the feet.

Diagnosis

If an abdominal aortic aneurysm is suspected, you likely will be referred for an abdominal ultrasound, a painless, safe test that can screen for and measure the size of an AAA. Computed tomographic angiography (CTA) can assess aneurysm size, location and the extent of impact. This study requires exposure to radiation and injection of an intravenous contrast agent. However, a CTA provides valuable anatomic information and can help your vascular surgeon determine the optimal type of repair.

Medicare Screening Benefit

Medicare offers a free, one-time AAA ultrasound screening for qualified seniors as part of their Welcome to Medicare physical during the first 12 months of their enrollment. Men who have smoked sometime during their life and men and women with a family history of AAA are eligible for this benefit.

Treatment

Vascular surgeons can determine the best procedure for you, based on the size of your aneurysm and other factors. For smaller AAAs, you may need to make lifestyle changes, such as quitting smoking and lowering blood pressure. You may be prescribed medication. Your surgeon will have you come back for regular checkups to see if the AAA has changed.

For large AAAs, or those that have been increasing in size over time, repair may be carried out either by placement of an endovascular stent graft or by open bypass grafting.

Be sure to see a board certified vascular surgeon. They have specific training in both minimally invasive and traditional open repairs. The type of repair conducted is very important to long term durability and freedom from rupture.

La Jolla Vein & Vascular runs  the diagnostic ultrasound for AAA, but will refer out for treatment.

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 abdominal aortic aneurysm2022-10-24T14:50:55-07:00

10, 6, 2022

What is Osteoarthritis?

2022-05-13T16:57:54-07:00

Osteoarthritis is the most common arthritis form that affects millions of people across the globe. While OA can affect any joint, it often damages the knees, hands, spine, and hips. Also known as wear and tear arthritis, the condition develops when the protective cartilage cushioning the ends of the bone in a joint wears away over time. Joints are parts of the body where two or more bones meet. These parts include your knee, hip, hands, backbone (any part of the body that you can bend has a joint).

The ends of the bones in a joint have a smooth, slippery surface referred to as the cartilage. This protective covering allows the bones to rub against each other without friction. Osteoarthritis causes the wear and tear of the cartilage between the bones, making the joint rough. The increased resistance at the joint causes stiffness, pain, swelling, and decreased ability to move.

While various treatments help in managing the OA symptoms, damaged joints are not reversible. Maintaining a healthy weight and staying active c will also help in slowing the disease progression. Although OA can affect both men and women at any age, individuals aged over 45 years are at an increased risk. Based on the research done by the Arthritis Foundation, osteoarthritis affects more than 27 million people in the USA alone, with the knee being the most susceptible part. Research also shows that women are at an increased risk of developing OA than men.

Osteoarthritis of the Knee

The most common cause of knee pain is knee osteoarthritis. The pain may come and go, become worse over time, or come accompanied by other symptoms, including knee stiffness. The condition develops due to degeneration of the cartilage. While the cartilage does not contain any nerves, damage or missing cartilage in the knee causes friction between bones and bone tissue changes, leading to pain. For example, damaged cartilage can lead to various bone changes such as:

  • Bone Spurs: Bone spurs, also known as osteophytes, are abnormal bony growth at the knee joints with damaged cartilage. The joint bones produce the bone spurs to compensate for missing or deteriorated cartilage. Bone spurs have an irregular shape that creates more friction in the knee joint, causing discomfort and pain.
  • Subchondral Bone Sclerosis: Due to undistributed weight loads, the tibia and femur surfaces, which lie beneath the cartilage, can change in composition, making it harden.
  • Cysts And Bone Marrow Lesions: Missing or deteriorated knee cartilage can also lead to cysts development and bone marrow lesions (areas of abnormal swelling). These cysts and lesions lead to knee discomfort and pain.

 

What is Osteoarthritis?2022-05-13T16:57:54-07:00

27, 4, 2022

3 Reasons to Wear Compression Stockings

2022-04-15T15:40:11-07:00

Why Compression Stockings:

Compression stockings are an important part of the overall healing process. As a result, you’ll need to wear the stockings following the vein treatments from La Jolla Vein Care to ensure you get the best outcomes. Physiologically, compression therapy increases venous blood flow back to the heart, reduces reflux in diseased veins, increases venous blood flow, reduces elevated water content of the tissue, reduces inflammation, and sustains reparative processes. In short, compression therapy not only improves results after treatment, but it also improves blood flow and reduces symptoms and swelling in the legs. 

 

Compression stockings offer style after vein treatment:

In the past, patients recovering from varicose vein treatments were limited in both mobility and style. After a procedure, patients were required to wear compression stockings in a lovely shade of beige. This might work if you’re looking to hang around the house for a couple months. If you’re ready to live an active life while you heal, however, you can get medical grade compression stockings that are fashionable, stylish, and comfortable.  At La Jolla Vein Care, you get more than a safe and effective alternative to surgery—you get access to customized compression stockings in a variety of styles from the leading brands, including Sigvaris, Medi, ComfoMed, Ames Walker, and JOBST.  While we are more than happy to order beige stockings for you, it’s good to know that you have options—the option to look good, feel good, and heal in style.

Compression stockings help prevent deep vein thrombosis: 

Stay moving, avoid prolonged sitting. For example, when flying or traveling, the risk of DVT is 1% on a long haul flight (greater than 6 hours).  

To minimize this risk, you should wear compression stockings (which helps increase the blood flow in the legs), stay hydrated, avoid excessive alcohol, use the calf muscles- walk about the cabin and frequently pump the calf muscles by doing foot lifts.

During pregnancy, compression should be worn and after pregnancy, when the risk of DVT is highest (the likelihood of a blood clot postpartum is 40-65 for every 10,000 women).

 

Compression stockings increase athletic performance: 

Compression is known for improving circulation after the removal of varicose veins. But can they improve athletic performance? The answer is a resounding yes. According to Medi, compression sport stockings are clinically proven to increase performance. Over the course of a marathon, for example, running time is reduced by approximately five minutes while the exertion on your muscles is reduced by roughly six percent. Moreover, a study by Technische Universität Dresden reveals that blood circulation is 30% higher at rest after engaging in certain athletic activities when wearing compression sport stockings. So whether you’re a jogger checking out the scenery or a hard-core athlete training for a marathon, there’s something to help you reach your peak.

 

3 Reasons to Wear Compression Stockings2022-04-15T15:40:11-07:00

A deeper look into chronic venous insufficiency

2022-04-15T15:36:06-07:00

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

 

Chronic Venous Insufficiency is progressive and worsens over time.

Chronic Venous Insufficiency is also known as venous stasis, or venous incompetence. Venous reflux disease refers to ‘leaky valves in the veins of the legs. Reflux may occur in the deep and/or superficial leg veins. The deep veins are those within the muscle; they bring at least 80-90% of the blood from the legs back to the heart. The superficial veins are outside of the muscle and under the skin. The main superficial veins are the Great Saphenous Vein that courses up the middle of the thigh and calf and the small saphenous vein, which courses up 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. Symptoms include leg heaviness, leg fatigue, leg pain, ankle swelling, phlebitis (inflamed and painful veins) , restless legs at night, and night cramps. Venous reflux disease is progressive and worsens over time. Skin changes may also develop, including darkening of the skin around the ankles. The darkening of the skin is sometimes referred to as skin changes. The skin can become dry and itchy (venous eczema). Eventually, the skin can break down causing a wound, called a venous leg ulcer. 

 

A deeper look into chronic venous insufficiency2022-04-15T15:36:06-07:00

Understanding Venous Stasis Dermatitis

2022-04-15T15:36:58-07:00

Understanding Venous Stasis Dermatitis

Venous stasis dermatitis is a change in the skin that occur when blood collects (pools) in the veins of the lower leg. ‘Stasis’ refers to pooling of the blood in the lower legs from venous insufficiency, and ‘dermatitis’ refers to the inflammation and related skin changes. Because of the inflammation, the skin around the ankles is usually itchy and discolored.

In venous stasis dermatitis, the skin of the ankles and lower legs may look thin or tissue-like. You may slowly get brown stains on the skin.The skin may become irritated or crack if you scratch it. It may also become red or swollen, crusted, or weepy.Over time, some skin changes become permanent. Thickening and hardening of the skin on the legs and ankles (lipodermatosclerosis)

Here’s what to look out for:

  • A bumpy or cobblestone appearance of the skin
  • Dark brown color

Venous stasis can cause skin sores (ulcers) may develop (called a venous ulcer or stasis ulcer). These most often form on the inside of the ankle. For this reason, skin changes are noticed around the ankle, you should see your doctor or vein specialist to stop the progression of venous insufficiency and prevent the skin from forming an ulceration.

  Stasis dermatitis

Chronic venous insufficiency over time can lead to skin changes and eventually ulceration. This image demonstrates stasis dermatitis (also known as venous dermatitis). Stasis dermatitis refers to the skin changes including skin discoloration around the ankles, dry itchy skin that can be thin, and it may eventually break down to cause an ulceration. You need to see a doctor if these signs are present.

Eight symptoms to watch out for:

  1. Swelling around ankles
  2. Heavy legs
  3. Varicose Veins, which can be twisted, bulging, dark, or purple
  4. Itching
  5. Pain
  6. Sores that ooze, crust or become scaly
  7. Thickened skin around ankles or your shins
  8. Hair loss on ankles and shins
Understanding Venous Stasis Dermatitis2022-04-15T15:36:58-07:00

Understanding The Stages of Venous Disease

2022-04-14T10:28:50-07:00

The six stages of Venous Disease include:

  1. Spider Veins
  2. Reticular Varicose Veins
  3. Venous Nodes
  4. Chronic Venous Insufficiency
  5. Trophic Ulcers
  6. Varicose Eczema

La Jolla Vein Care gives patients the tailored treatment plan for whichever stage they come in with. A diagnostic test is run called the Duplex Ultrasound. This displays a deeper look into the patient’s veins.

Venous reflux disease is also known as venous stasis, chronic venous insufficiency, or venous incompetence. Venous disease refers to ‘leaky valves in the veins of the legs. Reflux may occur in the deep and/or superficial leg veins. The deep veins are those within the muscle; they bring at least 80-90% of the blood from the legs back to the heart. The superficial veins are outside of the muscle and under the skin. The main superficial veins are the Great Saphenous Vein that courses up the middle of the thigh and calf and the small saphenous vein, which courses up 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. Symptoms of venous disease include leg heaviness, leg fatigue, leg pain, ankle swelling, phlebitis (inflamed and painful veins) , restless legs at night, and night cramps. Venous reflux disease is progressive and worsens over time. Skin changes may also develop, including darkening of the skin around the ankles. The darkening of the skin is sometimes referred to as skin changes. The skin can become dry and itchy (venous eczema). 

venous stage

 

 

Understanding The Stages of Venous Disease2022-04-14T10:28:50-07:00

16, 3, 2022

What are the adverse effects of Vein treatment?

2022-03-17T10:21:05-07:00

What are the adverse effects of Vein treatment?

Patients generally do very well with vein treatments, all of which have a low risk of complications. Some post treatment effects can include:

 

Aching over the treated veins is normal after vein treatment. This responds well to walking, ice packs, and anti-inflammatory medications such as ibuprofen (Advil, Motrin) or naproxen (Aleve). 

vein treatment pain

Bruising over injection sites is also normal after vein treatment and resolves in about two weeks. 

vein treatment bruise

Hyperpigmentation over a vein can occur from blood pigments that are released as the vein is healing. It is more common in patients with large bulging veins and certain complexions. Hyperpigmentation tends to fade over many weeks after vein treatment if you stay out of direct sunlight. 

deep vein clots

Intravascular hematoma refers to a large varicose vein that becomes firm and tender days to weeks after treatment. This also responds well to ice packs and anti-inflammatory medications. We may also recommend a confirmatory ultrasound and/or offer needle drainage of the trapped blood to alleviate discomfort and minimize skin pigmentation. 

 

Deep vein clots are very uncommon, and usually are limited to patients with poor mobility, advanced age, hormone treatment, and/or genetic tendency for clotting. We monitor all patients with ultrasound throughout treatment so we can detect clots at a very early stage before they cause a symptom. We may recommend surveillance ultrasounds, extra walking, and/or a short course of blood thinners. 

deep vein thrombosis

Numb spot over a treated vein is another uncommon event after radiofrequency or laser vein ablation. This occurs when a branch of a skin nerve gets stunned during the heat treatment. It tends to improve over several weeks. The nerves that control the movement of the leg and foot are located far from the superficial veins. 

 

What are the adverse effects of Vein treatment?2022-03-17T10:21:05-07:00

Understanding Venous Insufficiency

2022-12-13T14:11:01-08:00

When you become a patient with La Jolla Vein Care, 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. 

venous reflux disease

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. 

For any more questions about venous disease and the process of diagnosis and treatment, please call us at (858)-550-0330.

Understanding Venous Insufficiency2022-12-13T14:11:01-08:00
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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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