varicose vein removal

Five Common Myths About Varicose Vein Treatment

varicose vein removal

Five Common Myths About Varicose Vein Treatment

Since varicose veins and spider veins are so common, it’s not surprising that people have come up with unsubstantiated theories as to how they occur and how they are treated. In fact, it’s estimated that between 35% – 45% of people in the United States have varicose veins, and an even larger number have spider veins. More women than men have varicose veins, but they are not all uncommon in men.

Here are some of the most common myths concerning varicose veins:


Myth 1: Varicose Vein Treatment is Expensive

The most effective and widely-used techniques for varicose vein treatment, such as VNUS closure (Venefit™), EVLA (VenaCure®), sclerotherapy, and laser spider vein treatments, are minimally invasive and inexpensive.


Myth 2: Varicose Vein Removal Is Not Covered by Insurance

In approximately 80% of varicose vein removal cases are covered, either in whole or part, by insurance. Keep in mind that varicose veins are not only a cosmetic issue…the presence of varicose veins may be indicative of serious vascular disease. At the very least, varicose veins may worsen, causing pain. It’s worth a call to your insurance provider to see if any part of the procedure may be covered.


Myth 3: Varicose Veins Can Are Caused By Sitting With Legs Crossed, Or By Wearing High Heeled Shoes

There exists some old wives’ tales that daily habits such as sitting with your legs crossed or wearing fashionable high heels are causes of varicose veins, that is simply not true. While it is important for vascular health to get up and move around throughout your day, the act of merely sitting with your legs crossed or wearing a certain type of shoe will not result in varicose veins or spider veins. In fact, many people are genetically predisposed to varicose veins, others develop varicose veins after pregnancy, or other factors.


Myth 4: Varicose Veins Are A Cosmetic Issue; Treatment Is Optional

Untreated varicose veins may worsen, sometimes resulting discoloration of the surrounding skin, pain in the area, and chronic slow healing wounds. Most importantly, they can lead to blood clots, which may break off and block blood flow to critical organs. It’s important to get your varicose veins examined by a vascular surgeon, to make sure they are not a symptom of a more severe issue.


Myth 5: Varicose Vein Treatment Requires Invasive Surgery

Years ago, a surgical procedure known as vein stripping was the most common method of varicose vein treatment. In recent years, however, several non-invasive or minimally-invasive procedures have become the standard. Varicose vein treatments such as VNUS closure (Venefit™), EVLA (VenaCure®), sclerotherapy, and laser spider vein treatments, are minimally invasive, and affordable. They can be performed at your vascular surgeon’s office, and require little or no down time.



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Preventing Blood Clots While Sitting or Traveling

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Deep Vein Thrombosis (DVT), is caused when blood clots occur in the deep veins of the legs (and sometimes in the arms). DVT can be life-threatening, and people who travel are at a greater risk, due to the amount of time spent sitting. Anyone spends more than 3-4 hours travelling, regardless as to whether they travel by means airplane or ground transportation, should be aware of the risk of DVT (blood clots).
Basically, the longer your body is immobile, the higher the risk of blood clots. But travelers are especially at risk, because they sit in restrictive seating, often in the same position, for hours at a time. Without proper movement, or when one’s sitting position cuts off or inhibits circulation in the legs (especially if legs are crossed), blood clots can occur in the deep veins.
The deep veins are located in the interior of the body, such as the femoral vein, tibial veins, ulnar and fibial veins, etc. These are not visible to the eye, as may be the superficial veins that are located closer to the skin’s surface. When you get varicose veins or spider veins, these veins become more visible due to blood pooling in the area where a venous valve has become faulty. Treating spider veins and varicose veins is usually simple and painless, due to their location near the skin.

Back to blood clots in the deep veins. While these clots can sometimes dissolve or break up on their own, the real risk is that the clot gets carried away from legs back toward the lungs (for oxygenation), where it may clog or block a pulmonary artery. This prevents blood flow to the lungs, which is life-threatening. It helps to take precautions against blood clots while traveling or sitting for long periods, and to know the symptoms.

In addition to extended sitting, several risk factors may increase the likelihood of a blood clot.
Even if you travel a long distance, the risk of developing a blood clot is generally very small. Your level of risk depends on the duration of travel as well as whether you have any other risks for blood clots. Most people who develop travel-associated blood clots have one or more other risks for blood clots, such as:


Risk factors:
• Varicose veins: if varicose veins are left untreated, circulation in that area will be less than if the varicose veins had been treated
• Age: risk increases after age 45
• Obesity: excess weight places a strain on the circulatory system
• Recent surgery or injury involving deep bruising, stiches or bleeding.
• Periods of immobility or bed rest
• Hormone use, especially estrogen, for such uses as birth control or hormone replacement
• Pregnancy or recent childbirth (due to increased pressure in the veins)
• Previous blood clot or a family history of blood clots
• Smoking (inhibits circulation)
• Chemotherapy treatments

What are the symptoms of DVT?
While a deep vein blood clot may occur with no detectable symptoms, when symptoms are present, one might notice swelling, tenderness, feverish skin, feeling of fatigue in the affected limb, redness, visibly swollen veins in the affected limb.
If you have any of these symptoms, seek emergency medical care immediately.

If DVT reaches the lungs and causes a Pulmonary Embolism, the following symptoms may appear.
Symptoms of a Pulmonary Embolism may include:
1. Feeling faint or dizzy
2. Difficulty breathing
3. Accelerated (and possibly irregular) heartbeat
4. Chest pain
5. Sudden coughing with blood or blood in mucous
If you have any of these symptoms, seek emergency medical care immediately.


How to prevent DVT while traveling or sitting for long periods
Get up and move around as much as possible.
If you can’t get up, move your arms and legs. Change positions, stretch, flex and release the muscles in your arms and legs. Point and flex the toes, move the ankles in a circular motion, raise and lower the legs, make a pumping motion with your feet. Alternate raising your knees to your chest. For arms, roll your shoulders, flex and release your biceps, make wrist circles, raise and lower arms.

Thanks for reading! Stay informed, stay safe, and happy travels.

Please visit us on the web at for more information, or to schedule a consultation. Our team of board certified vascular doctors treat all conditions of the vascular system, from varicose vein treatment and spider vein treatment, to wound care and more serious vascular diseases.


1Gavish I, Brenner B. Air travel and the risk of thromboembolism. Internal and Emergency Medicine 2011 Apr;6(2):113-6.

varicose vein treatment

Standing all day for my job…will it cause varicose veins?

Being required to stand all day, or for long periods of time daily, can be the root cause of vein issues.

varicose vein treatment

The average person works 40+ hours per week, during which they are either sitting or standing. As we all know, many people work more than 40 hours per week. Additionally, other activities outside of work also involve standing, which further compounds the negative effects of standing. Standing for such a significant chunk of your time can lead to various health issues, including foot, back and knee problems, and vein or circulation problems.

Standing for long periods of time can be uncomfortable, which in itself is a sign from your body to change positions. Associated pain from standing may include foot, leg or back pain. However, standing for long periods also increases the likelihood of developing varicose veins, for which you wouldn’t feel any associated aches or pains. Your legs may feel fatigued, but when you first notice varicose vein, they symptoms will most likely be visible, as the reddish-purple network of veins appears on your legs, behind the knees, or ankles.

Sitting is not the best solution, as sitting for long periods also contributes to varicose veins. In addition to affecting the circulatory system and causing varicose veins, sitting is also closely associated with back and neck pain, sciatic nerve problems (often chronic), and carpal tunnel syndrome (due to improper height of hands and keyboards at standard chair and desk heights).

It’s noteworthy that not all individuals who are required to stand for long periods develop varicose veins or spider veins, and there is no way of predicting who will develop varicose veins. Those with a family history of varicose veins should pay attention, as they are most likely at a higher level of risk.

In addition to causing varicose veins and spider veins, standing for long periods daily over several years can increase atherosclerosis, due to the demands standing places on the circulatory system.


I can’t change my job, so, what’s the solution?

We’ve all heard experts recommend that we take breaks often, at least once per hour. But taking a break from standing by just sitting down will not offer much help. Try to walk as often as possible, stretch several times throughout the day, and put your feet up as often as possible.



The purpose of veins is to return blood to the heart for oxygenation. Think about how much harder the veins have to work to push the blood up to the heart from the feet and legs, while in a constant standing position. It is a constant fight against gravity, that can eventually weaken the one-way valve that facilitates the movement of blood. Once this valve is weakened, the blood pools and backflows in the area, causing the area of the vein to bulge, and also resulting in the visible purple-blue varicose veins or spider veins.

So, as much as you can do to facilitate circulation, the better. Go for a walk. Do a few yoga poses. Sit in a recliner with your feet up. Go for a swim. But do these activities throughout the day to break up the constant standing activity. It’s all about balance, right?

Already have varicose veins or spider veins? No problem. Varicose vein treatment is fast, simple, and painless. But get your varicose veins taken care of now, because allowing them to worsen can lead to greater health problems. Also, your varicose veins might not necessarily be the result of standing, you’ll want to have them checked by a vascular surgeon to make sure they are not the result of a more serious vascular disease.

Contact the San Diego Vascular Center today for your consultation and varicose vein treatment. Visit us at



The Anatomy of Veins and Arteries

Before explaining the anatomy of your veins, let’s have a quick overview of your cardiopulmonary system. The cardiopulmonary system consists of a network of blood vessels, the lungs, trachea and bronchi.  The system comprises organs from both the circulatory and respiratory systems, to carry nutrients, oxygen and hormones throughout the body, as well as to removes waste. This network begins oxygenated blood is transported from the lungs to the heart via the pulmonary veins. The oxygenated blood is then transported throughout the entire body. Then, the deoxygenated blood is returned to the heart at the right atrium of the aorta, via the inferior and superior vena cava.


The Function of Arteries and Veins

While both arteries and veins are blood vessels, they are quite different. Arteries carry oxygenated blood to the organs and limbs, while veins carry the deoxygenated blood back to the heart for re-oxygenation. The only exception are the pulmonary veins, which carry oxygenated blood from the lungs to the heart.

Veins contain a smaller mass of muscle tissue than arteries, and are located in closer proximity to the skin’s surface. Arteries transport nutrient-rich blood away from the heart, while veins carry blood back toward the heart. Veins differ from arteries in that they contain valves which keep the blood moving in one direction, without risk of reflux or back -flow.


Vein and Artery Structure

Tunica adventitia – The resilient outer layer of both arteries and veins, comprised of collagen and elastin.

Tunica media – The middle layer of both arteries and veins, comprised of smooth muscle and elastin fibers

Tunica intima – The interior lining of both veins and arteries, which contain the hollow passageway for blood to flow, called the Lumen. Veins contain one-way valves, which allow blood to move back to the heart and lungs against gravity, without risk of back flow.

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How Are Varicose Veins and Spider Veins Caused?

As mentioned earlier, veins are unique to arteries in that they contain one-way valves to carry blood to back to the heart and lungs. Also, most superficial veins are closer to the surface of the skin. Sometimes, the valve inside the vein malfunctions, causing blood to pool in an area of the vein. This pooled blood becomes visible through the skin’s surface. When this occurs in smaller veins and capillaries, we refer to the condition as spider veins. When we see larger darkened and bulging veins, we refer to them as varicose veins.

While they can be unsightly, spider veins are not painful, and do not lead to serious complications. However, they can begin to worsen if untreated. Fortunately, spider vein treatment is fast, safe and completely painless. Both varicose vein treatment and spider vein treatments consist of closing the afflicted vein, by a variety of methods.

Most cases of varicose veins are painless, and also without complication. However, there is a considerable number of cases that have reached the point of discomfort, wherein patients complain of aching, painful limbs. If left untreated, serious cases of varicose veins can lead to ulcers, blood clots, or rupture/bleeding. Thankfully, varicose vein treatment is simple, painless and highly effective. The most popular varicose vein treatments are VNUS Closure (Venefit), EVLA (VenaCure), sclerotherapy, or laser treatment.


If you are considering varicose vein treatment or spider vein removal, please come in for a consultation with our team of board-certified vascular surgeons at the San Diego Vascular Center.

The San Diego Vascular center is located in San Diego, yet easily accessible from Orange County and Riverside County.


Factors Affecting Chronic Wound Healing


Many factors and causes are associated with slow healing or chronic wounds, and sometimes a combination of factors are involved in interrupting one of the phases of wound healing. Let’s look at the leading causes of chronic wounds:


Diminished ability to heal from wounds, or chronic wounds requiring wound care, as well as chronic diabetic foot ulcers, are common effects of the diabetic condition. The phenomenon of chronic diabetic wounds is based on a complex interplay of physiological mechanisms.  Deficiency of oxygen at the wound site, known as hypoxia, is caused by hyperglycemia. Excess sugar in the bloodstream causes cell walls to thicken, thereby inhibiting blood flow to the wound site. The hemoglobin insufficiency results in lack of oxygen, white blood cells and proper nutrients. Wound healing and wound care complications are sizeable factors in morbidity rates among diabetics.



When the seven-layer barrier of skin is broken, bacteria and other micro-organisms can enter below the dermis. There, they can colonize and spread rapidly. Infections can either be the result of a chronic wound, or be the cause of a chronic wound. Micro-organisms may enter a chronic wound and cause complications with healing. Similarly, the spread of infection at a fresh wound site may severely limit the ability of the wound to heal normally, resulting in a chronic wound that requires wound care.



Advanced age has been shown to be a major risk factor for slowed or inhibited wound healing. While diminished wound healing ability is predominately due to decreased hormone levels in the elderly population, reductions in t-cell production and inflammatory response are also key contributing factors.

With regard to hormone levels, we attribute higher estrogen levels in women (specifically estradiol, for its cell growth capabilities) to studies showing better wound healing statistics for elderly women, as opposed to elderly men.



Obesity, as a condition, correlates with impaired wound healing, as well as chronic wound infection, especially with regard to post-surgical wound healing. Poor perfusion (circulation) through excess tissue results in lack of necessary oxygenation and nutrition at the wound site. Additionally, increased pressure caused by excess body weight places further burden on circulation.



Without getting too technical, chemotherapy drugs are designed to prohibit the growth of cancer cells, and as a result, also prohibit necessary cell growth, collagen formation, and tissue regeneration at the wound site. Chemotherapy drugs also stifle the body’s immune response, resulting in significantly increased rates of infection and chronic infection. Chemotherapy drugs may also restrict healthy blood clotting at the incision, leading to excessive bleeding.


Cigarette Smoking:

The health consequences of frequent tobacco smoking have been documented for decades. Specific to wound healing, tobacco use restricts oxygen delivery to the wound, which, as we discussed earlier, greatly affects the body’s ability to heal. Nicotine use alters the consistency and chemical make up of the blood, with lowered levels of oxygen in the bloodstream in general, in addition to decreased circulation. Long-term smoking is linked to thickening of the arteries (atherosclerosis), which limits blood flow and subsequent oxygenation and nutrition. The process of burning tobacco creates carbon monoxide as a by-product, which, when inhaled, also suppresses proper oxygen levels in the blood.


Other Factors:

In addition to the above-mentioned causal factors of chronic wounds, poor diet, stress and frequent alcohol consumption can also affect wound healing.


Wound Care:

Chronic wounds should be treated holistically, taking all factors of a patient’s health into consideration, in addition to any diseases or medications they may be taking. Vascular surgeons treat and dress wounds, often with compression, to improve circulation and nutrition to the wound site, in a sterile environment. Proper cleansing of the wound site is also routine. Sophisticated analysis would lead a vascular surgeon to determine if curettage is required to remove damaged tissue, or if tissue is healthy enough to recover.
The San Diego Vascular Center is Ssan Diego’s foremost vascular treatment center. Whether you are looking for spider vein removal in San Diego, or need a reliable, highly-qualified staff to care for chronic wounds or vascular disease, you are in good hands with our team of board-certified doctors.





Varicose Veins and Pregnancy

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First of all, what are varicose veins?

Varicose veins are bulging, purple or bluish veins that appear close to the skin’s surface. They are most commonly found on the legs and ankles, but may also appear in the pelvic region or other areas. Varicose veins may have little or no discomfort, or they can be extremely uncomfortable. They can even lead to ulceration of the nearby skin.


Why do varicose veins are most often occur in the legs?

It’s important to remember that the function of the veins is to return blood to the heart…this means the leg veins are pumping against gravity. A one-way valve system in the veins insures the blood will move along in one direction, however, excess strain or pressure on the veins may cause damage to those one-way valves. When valves are not functioning properly, blood may pool in the areas, causing the vein to bulge and appear darker in color.


So, what do varicose veins have to do with pregnancy?

While there are various causes of varicose veins, such as heredity, standing or sitting for prolonged periods, menopause or obesity, a common cause of varicose veins is pregnancy. As the size of the uterus continually increases during pregnancy, it puts more and more stress on the interior leg veins (inferior vena cava), which directly affect the leg veins. Pregnancy also causes increased blood flow throughout the body, which can lead to enlarged veins.


How can you prevent or minimize varicose veins during pregnancy?

Keep in mind that leg veins fight against gravity to transport blood back to the heart. Therefore, anything that you can do to limit the effects of gravity will be greatly helpful. For example, keeping legs elevated as often as possible is one of the best things you can do to prevent varicose veins during pregnancy. Also, the more weight you put on, the more weight your legs have to fight against, so it is highly advisable to maintain the weight range recommended by your doctor. Daily exercise is also important to keep circulation going, including moderate exercise such as walking. Wearing compression stockings also helps support the leg veins, making their job easier.

While we’ve just listed several things you should do, it’s also important to note what you shouldn’t do. It is crucial to avoid sitting or standing for long periods at time. Make sure to rest, elevate your legs, or get up and walk around regularly to improve circulation and lessen the effects of gravity. Avoid tight-fitting clothes and shoes, that may restrict circulation.


If I develop varicose veins during pregnancy, should I be concerned?


For the most part, varicose veins are not serious, and treatment can wait until after delivery. There are a few instances in which one should see a vascular doctor, even during pregnancy. If varicose veins become painful or ulcerated, your vascular doctor can determine if they need immediate treatment.

Report any pain or swelling in the limbs to your vascular doctor, as pain and swelling may indicate Deep Vein Thrombosis (DVT), a condition wherein a blood clot may form in the deeper leg veins. These blood clots are dangerous, as they may break off and be carried to the lungs, which results in a serious condition known as Pulmonary Embolism. If you experience pain in the chest area, rapid heartbeat, or coughing up blood, call 911 immediately.

Also, there is a condition known as superficial venous thrombosis, wherein a small blood clot may occur near the skin’s surface. The area may become swollen and painful, and may cause burning or heat sensations. Please see your vascular doctor if you experience any of these symptoms.


What are my varicose vein treatment options?

Varicose veins cause by pregnancy tend to improve after giving birth, so as long as the symptoms are mild with no pain, it is advisable to wait 3-4 months before seeking varicose vein treatment, to see how much they improve on their own. You can greatly assist the healing process by remembering to exercise, elevate the legs, and wear compression hose.

Once you’ve decided that you want to have the varicose veins removed/treated, there are several options:



VenefitTM also known as VNUS closure, uses radiofrequency to shrink varicose veins, minimizing their appearance, and re-routing blood flow to healthier veins.



Sclerotherapy is used for both spider vein treatment and varicose vein treatment. Sclerotherapy is a safe, non-surgical procedure by which a solution is injected into the faulty vein, causing it to safely close.


Endovenous Laser Ablation

Endovenous Laser Ablation, or EVLA, uses laser energy to shrink and close damaged veins. The procedure is minimally invasive, whereby a small laser fiber is inserted into the vein. The procedure is quick and painless.

In summary, while there are many causes for varicose veins, pregnancy is a common cause (especially if you’ve had multiple pregnancies). The condition is rarely serious, however, you should be aware of symptoms that may indicate a more serious condition. Take steps to prevent or minimize varicose veins during pregnancy, and know that treatment options are safe, painless and highly effective. Thanks for reading!


The San Diego Vascular Center specializes in diagnosis and treatment for any and all vascular health issues for patients in San Diego County, Orange County and Riverside County. For more information or to set an appointment, please contact us.


Directions from Riverside: Take the 91 E. Follow the I-215 S and I-15 S to Gamble Ln in Escondido. Take Exit 29 from the I-15 S. Continue on Gamble Ln to W Citronado Pkwy.


Directions from Orange County: Take the 5 S and CA-78 E to Gamble Ln, Escondido. Take Exit 29 from the I-15 S. Continue on Gamble Ln to W Citronado Pkwy.



Varicose Veins Originating in the Pelvic Region (Pelvic Venous Congestion Syndrome)

Varicose Veins Originating in the Pelvic Region

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Most people think of varicose veins as a condition that occurs in the legs. That certainly was the case for Marylin of Orange County, CA, until she found out she was one of 15% of women with varicose veins whose condition originates in the deeper veins of the pelvis. In fact, many women with varicose veins in the legs have sought treatment from doctors who treated the leg veins only, not realizing the condition originated in the pelvis, which led to a recurrence of the leg varicose veins.


Ovarian veins in the pelvis join the inferior vena cava and the left renal vein in the legs. When the valves in the veins become obstructed or damaged, it affects the flow of the blood  heading back to the heart, the blood then flows backwards (i.e. the wrong way, away from the heart). This causes the varicose veins in the pelvis area, often leading down the thigh and leg area, and resulting in significant pain.


Marylin, like many women that have had two or more children, was a high risk for Pelvic Venous Congestion Syndrome, which is theorized to be caused by pressure on the pelvic veins from the weight of the baby in the womb, accompanied by increased blood flow to the area during pregnancy. Venous blood flow in the area may also be obstructed by polycystic ovaries.


If Marylin did not investigate further, she may have become one of many women with varicose veins in the legs who had to keep going back for recurring varicose vein treatments, as the cause of the varicose veins originating in the pelvis is often undiagnosed. Luckily, Marylin’s research brought her to the San Diego Vascular Center, which is only a short drive from Orange County for varicose vein treatment.



Symptoms may include generalized chronic, aching pain in the pelvic or lower abdominal area, sometimes accompanied by feelings of heaviness or fullness of the legs. Intensity of pain may vary according to level of physical activity, menstrual cycle, or fatigue. In Marylin’s case, standing for long hours at her job led to marked increase in pain symptoms, whereas lying down mitigated the pain.



Visual examination often indicates varicose veins in the pelvic or upper/inner thigh region. Transvaginal Ultrasound has been found to be effective in detecting varicose veins of the pelvic veins, as well as MRI imaging. Imaging is a critical step to determine in which veins the problem originates, so they can be targeted for treatment. Pelvic venography is often used for precise imaging, either prior to pelvic varicose vein treatment, or at the time of treatment.



Most doctors will begin with hormone therapy or drug treatment (medroxyprogesterone acetate or Goserelin are effective in decreasing vein diameter and minimizing varicose veins) before deciding to move forward with invasive treatment. Treatment of pelvic varicose veins or pelvic congestion syndrome is similar to treatment of varicose veins in the legs, using either sclerotherapy or pelvic vein embolization.

Pelvic vein embolization is minimally invasive, and occurs under local anesthetic. X-ray imaging is utilized to help the vascular surgeon or interventional radiologist through the process of inserting a small catheter into the afflicted veins, whereby sclerotherapy, coils, or both, will be injected into the vein to close off the veins with faulty valves. The body responds by naturally rerouting blood flow to healthy veins.


There is minimal discomfort during the procedure; most patients describe only sensations of pressure, and no pain. Patients can return to normal activity levels soon after the procedure, with little or no down time, although it is recommended to rest for 48 hours following the procedure.


The San Diego Vascular Center specializes in diagnosis and treatment for any and all vascular health issues for patients in San Diego County, Orange County and Riverside County. For more information or to set an appointment, please contact us.


Are You Familiar with the Different Types of Peripheral Vascular Disease?


Doctors refer to peripheral vascular disease, however, the term includes several different conditions. Under the classification of peripheral vascular disease, one might be referring to Deep Vein Thrombosis (a.k.a. DVT), Varicose Veins, Chronic Venous Insufficiency, Thrombophlebitis, Atherosclerosis, Thromboangiitis Obliterans (Buerger’s Disease), or Raynaud’s Phenomenon.

varicose vein treatment

Let’s take this opportunity to provide a brief overview of each one. But first, it is important to know the difference between deep veins and superficial veins.

Deep veins are larger veins located within the leg muscles. These veins return nearly all the body’s blood supply back to the heart, pushing the blood upward against the force of gravity.

Superficial veins are smaller veins located just beneath the surface of the skin. They pump a smaller volume of blood back to the heart. When people seek spider vein removal or varicose vein treatment, they are referring to superficial veins.

And now, back to peripheral vascular disease.


Deep Vein Thrombosis

The medical term for a blood clot is a thromb; and deep vein thrombosis refers to blood clots or thrombs that form in the veins deep within the muscle groups in the legs. Symptoms of DVT include pain, swelling, and cramping of the leg. In some cases, the area appears bluish or purple, and may be warmer in terms of temperature in relation to the rest of the body.

DVT is a very serious condition, because at any moment, the blood clot can break free, follow the path of blood back to the lungs to be oxygenated, where it may block a pulmonary artery. This is known as a pulmonary embolism, and is a life-threatening emergency.



Keeping in mind that blood clots are referred to as thrombs, the name thrombophlebitis describes a blood clot that usually occurs in the superficial veins closer to  the skin’s surface, as opposed to Deep Vein Thrombosis. Symptoms of thrombophlebitis can range from pain, swelling and discoloration, to disruption of normal circulation in the limbs or extremities, and even fever. A venogram, CT scan or MRI can determine the location of the blood clot. A vascular surgeon would determine if the treatment would involve vein stripping, or anticoagulant medication which can break down and diminish the blood clot.


Varicose Veins

Despite many online claims, there is no known topical or natural remedy for varicose vein treatment or spider vein treatment. Varicose veins and spider veins are caused when the one-way valves that move blood along toward the heart become damaged, causing blood to flow backward and pool in the damaged vein area. This is what causes the reddish-purple appearance of the varicose veins. There is nothing a cream or herbal remedy can do to repair the damaged vein. The only solution is to close the damaged vein, and reroute the blood flow through nearby healthy veins.

Treatment for varicose veins and spider veins involves little or no pain, as well little or no downtime. If the varicose vein condition is left untreated and begins to worsen, the patient will feel pain and fatigue in the affected area. Varicose treatment and spider vein treatment are performed by vascular surgeons using laser treatment or sclerotherapy.


Chronic Venous Insufficiency

While varicose veins and spider veins can be considered insufficiencies of the superficial veins, when the condition becomes chronic and spreads to include the deeper veins, it is known as Chronic Venous Insufficiency. This condition may also be attributed to a genetic venous valve insufficiency. CVI is very serious, and often leads to infections and chronic skin ulcers.



Most people are familiar with, or have at least heard the term Atherosclerosis, due to the condition’s prevalence and severity. The disease occurs when the smooth walls of the arteries deteriorate in condition to where they become rough and therefore, allow plaque from low density lipids (cholesterol) and microphage white blood cells to build up progressively, until the arteries become too narrow for adequate blood flow.

Although they sound similar, this condition is not to be confused with Arteriosclerosis, wherein the arterial walls become hardened.


Thromboangiitis Obliterans (Buerger’s Disease)

Thromboangiitis Obliterans involves chronic thrombosis occurring in the small-to-medium sized veins in the legs. The extensive blood clotting causes thrombophlebitis, ulceration, and even gangrene or necrosis. Symptoms include pain, discoloration, swelling, necrosis, and difficulty detecting a pulse in the affected extremities. The disease is more common among smokers, as well as those with a history or genetic predisposition to heart disease or diabetes. Causes for atherosclerosis include smoking, genetics, diabetes and/or high blood sugar, with smoking being the most prominent causal factor.


Raynaud’s Phenomenon

Raynaud’s Phenomenon occurs in the extremities, usually fingertips or toes, causing blood vessels to constrict and limit blood flow. Fingers or toes may appear white or blue while circulation is cut off, then will appear reddish in color as circulation returns. Patients report that the sudden, diminished circulation correlates with exposure to cold temperatures, as well as stress. Treatment includes lifestyle changes to keep warm and improve circulation, and prescription of calcium channel blockers or alpha blockers to increase blood flow.


The San Diego Vascular Center specializes in diagnosis and treatment for any and all vascular health issues for patients in San Diego County, Orange County and Riverside County. For more information or to set an appointment, please contact us.



Kesieme E, Kesieme C, Jebbin N, Irekpita E, Dongo A. Deep vein thrombosis: a clinical review. Journal of blood medicine.
2011;2:59-69. doi:10.2147/JBM.S19009.


Eberhardt, Robert T., Chronic Venous Insufficiency. 2005. Circulation, Volume 111, Issue 18.


Are Spider Vein and Varicose Vein Treatments Covered By Insurance?

by Androniki Bossonis


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One of the most common misconceptions about varicose and spider veins that many doctors (as well as patients) believe is that varicose vein treatments and spider vein treatments are considered cosmetic in nature, and therefore not covered by insurance. While this is true under many circumstances, ascribing to this myth can have possible health consequences for those who have the more serious variation of the venous disease. Specifically, that they might avoid varicose vein treatment due to the potentially false belief that they must cover the entire cost as an out-of-pocket expense.

As your vascular surgeon can attest, vein disease is serious. However, when there are many med-spas and similar cosmetic treatment centers that address only the cosmetic variety of spider veins and varicose veins, who also do not work with insurance on those procedures, it is understandable how the misconception has proliferated greatly.

Patients should look for certain symptoms that may indicate that the superficial varicose veins may be progressing to or may be indicative of a more serious vascular disease, such as phlebitis, Deep Vein Thrombosis, blood clots, or open sores or skin ulcers.

Important symptoms to watch for, in the area of the varicose and spider veins, include tenderness or pain, wounds or ulcers, throbbing sensation, burning or tingling feeling, feelings of tiredness and fatigue in the legs, or veins protruding noticeably far or getting worse. If any of these symptoms are present it’s time to head to a doctor…a vascular doctor or vascular care center.

Your vascular specialist will be able to tell if your spider vein and varicose veins represent a more serious underlying issue, such as venous reflux disease. At this point, they can also verify your health insurance policy for coverage. Most venous diseases (that are more than just superficial) are covered by insurance, especially due to the serious nature of vascular disease.

Patients should never prolong varicose vein treatment just because they suspect the varicose vein treatment might not be covered by insurance. Recent studies across various ethnic groups, genders and ages in Orange County, Riverside County, Los Angeles and San Bernardino counties, showed 83% of participants exhibited varicose veins or spider veins. Varicose veins were more common among women, and varicose veins increased with age. The study also revealed that 11% of all subjects with vein disease had more serious (functional as opposed to cosmetic) vein disease, which would have been covered by most health insurance plans.

The San Diego Vascular Center specializes in diagnosis and treatment for any and all vascular health issues for patients in San Diego County, Orange County and Riverside County. For more information or to set an appointment, please contact us.


Reference: Langer, R. D., Criqui, M.H., Denenberg, J., Fronek, A. (2000). “The Prevalence of Venous Disease by Gender and Ethnicity in a Balanced Sample of Four Ethnic Groups in Southern California”, Plebology. University of California, San Diego, La Jolla, California, USA.



San Diego Vascular Center Customer Testimonials

San Diego Vascular Center Customer Testimonials

We gathered together a small collection of comments from San Diego Vascular Center customers from San Diego, Riverside and Orange Counties. We hope they help you feel confident about our vascular care services, ranging from spider vein treatment and varicose vein removal, IPL Laser treatments, Laser Hair Removal, to wound care and care and serious vascular disease treatment.

 wound care

Varicose Vein Treatment:

“I had noticeably large varicose veins in my legs from a young age, due to heredity. I was very self-conscious, and refrained from wearing shorts or swim suits. I am so relieved after having the varicose veins removed. I can wear anything now, and feel completely confident. The treatment was a breeze, and doctors and staff treated me like gold.”

~Mona T., Aliso Viejo, Orange County, CA


“I developed varicose veins in my thirties, but held off for many years on getting them removed, because I had a fear of doctors and treatment. The veins got worse and worse and worse over the years, and eventually became painful. The doctors and even the receptionist staff at San Diego Vascular Center were so caring and gentle with me, I knew I was in good in hands. The procedure was fast and painless. If I had known that the varicose vein removal would have been so easy, I would have done it years ago.”

~Alyssa M., Riverside CA


Spider Vein Treatment

“I developed spider veins in several areas when I reached my mid-forties. They were on my legs, my ankles, and on my nose and cheeks. I thought that it would be an expensive undertaking due to how many areas I was affected by, so I didn’t pursue spider vein removal right away. Finally, my youngest son told me that my nose looked like a map, and I made an appointment (after doing some research, of course). The laser procedure on my face and ankles was non-invasive, fast and painless. They used an injection on the larger spider veins in my legs, and I watched them disappear before my eyes. I know it is a cosmetic procedure, but it is a big relief to feel confident and not embarrassed anymore. Thank you.”

~Denise R., San Clemente, Orange County, CA


Wound Care

“I brought my mother to San Diego Vascular Center for her diabetic wounds, after a referral from her primary care physician. My mom was in pain, and very nervous about treatment. I want to take a moment to write this thank you to the doctors and kind, caring staff at San Diego Vascular Center. Just looking at her foot today I can see how much better it is, and my mom is not only healthy, but very happy.”

~Ellis P., San Diego, CA


“I suffered from pressure wounds for about 18 months. Most people have no idea what this is like…not only is it a source of anxiety and extreme discomfort, but they are prone to getting infected. My body was constantly fighting infection. I would go to a doctor for treatment, but the wounds would never heal, and the infections would return. I live in Orange County, but I met Dr. Bulkin at a North County Health & Wellness fair while visiting San Diego. Dr. Bulkin impressed me with his knowledge and his manner.

After 18 months of anxiety and suffering, my wounds were healed in about 6 weeks. The San Diego Vascular Center not only cleaned and treated my wounds, but they did a holistic health assessment, and taught me more about how to care for myself and my wounds than I could ever imagine. Thank you for allowing me to move past this chapter and feel healthy and optimistic again.”

Emmaneul M., Irvine, Orange County, CA


Vascular Disease – Aortic Aneurysm

“Dr. Bulkin spoke at the nursing home where I stay. I told him that I have been having high blood pressure after a knee surgery, and I was going to speak to my doctor about how the surgery could have cause my blood pressure to skyrocket. He told me to come in immediately, because surgery would not cause high blood pressure. He saved my life. I had an abdominal aortic aneurysm, and could have died at any moment. I was a walking time bomb. With caring and reassurance, they scheduled me for surgery immediately to have the damaged aorta section replaced. If you suddenly experience high blood pressure or pain in the stomach area, it is worth getting checked immediately. I recommend the San Diego Vascular Center with my highest recommendation.

~Sergio B. , San Diego, CA