What questions do you have?

What are Varicose Veins?

Varicose veins are dysfunctional/incompetent veins in the lower extremities. Vein wall injury allows the vein to elongate and dilate, leading to an increase in vein diameter, valve dysfunction, reflux, and the visual manifestations of varicose veins.

What causes Varicose Veins?

It is currently believed that a dysfunctional venous system can result from injury to vein walls and venous valves. This type of injury entails acquired severe inflammation exacerbated by factors such as heredity, obesity, female gender, pregnancy and a standing occupation.

Will insurance cover my treatments?

Spider veins are cosmetic in nature and therefore, NOT covered by insurance. Varicose veins, on the other hand, may be covered by PPO insurances and Medicare, subject to their medical guidelines and criteria. If you would like to find out more about insurance coverage, please contact our office and our staff will be happy to assist you.

Why do I need an ultrasound exam?

The first step in finding the right treatment for damaged veins is finding its source. A Doppler Duplex Ultrasound Scan provides a visual window, revealing the diseased, refluxing veins beneath the skin’s surface. With this diagnostic capability, we can pinpoint the exact cause of varicose veins and customize a treatment plan for each individual patient – and each damaged vein. Because the problem is dealt with at its source, the treatments are quicker, more effective and less painful than traditional methods, such as vein stripping.

What is Endovenous Laser Ablation (EVLA)?

This is a well-tested procedure that replaces vein stripping. Under duplex ultrasound guidance, a laser fiber is inserted into the dysfunctional vein and positioned at the base of the terminal valve. Laser energy is then delivered to the tip of the fiber while it is slowly withdrawn. This process enables shrinkage and ultimately closure of the vein wall.

What can I do to prevent varicose veins?

While you cannot entirely prevent varicose veins, there are quite a few ways to improve your vein health. Physical activity, such as walking, swimming or cycling, is a wonderful way to pump blood up the leg against gravity to improve circulation. Compression hose also helps improve circulation by preventing blood from pooling in the leg veins.

What is compression therapy?

Compression therapy such as compression stockings is a fundamental strategy in the treatment of venous dysfunction. Despite recent therapeutic advancements in leg vein treatment, compression remains a simple, effective, and inexpensive modality. It is used as a primary treatment as well as an adjunct when other treatments are employed.

Why would a superficial clot dissolve, but not a deep vein clot?
 

I have a deep vein clot and a superficial clot. The superficial clot is almost completely gone. I had another ultrasound at 6 months, and the doctor said nothing is dissolving with the deep vein. Why wouldn’t the deep vein not dissolve? Sometimes clots do not dissolve and form scar tissue which is permanent. If this happens in the deep system and leads to a condition called post-thrombotic syndrome. This can create lifelong issues for that leg. If the blood flow is somewhat compromised a stent can be placed on occasion to open up that vein.

Do I have Spider Veins or Varicose Veins?

My husband has had at least 6 superficial blood clots in the last 3 months. What could be causing these so often? Is there a deeper problem? He has been evaluated at the ER for this and they confirmed they are superficial. We are waiting for insurance to kick in next month, but thought I would see if I could get any more info beforehand. If he has varicose veins it could simply be due to this. On the other hand, he could have a clotting disorder and would need to have a workup for this. This is often done by a hematologist and is a blood test.

Can I take a 12-hour flight if I have CVI? What should I do to prevent DVT?

I was diagnosed with CVI last year. I have heavy, achy legs all the time. I am wearing 20-30 mmHg thigh-high compression stockings daily. My parents are overseas. I know I will not take flight unless absolutely necessary. If I need to take a 12-15 hour flight for an emergency situation, is it safe? A business class seat is a must and so is walking in the cabin every hour, but what else can I do to prevent DVT? The compression hose is fine. The business class seat and frequent walks is nice but not essential. You can do frequent leg motions like "pumping the gas pedal" in an economy seat.

What causes frequent superficial blood clots?

My husband has had at least 6 superficial blood clots in the last 3 months. What could be causing these so often? Is there a deeper problem? He has been evaluated at the ER for this and they confirmed they are superficial. We are waiting for insurance to kick in next month, but thought I would see if I could get any more info beforehand. If he has varicose veins it could simply be due to this. On the other hand, he could have a clotting disorder and would need to have a workup for this. This is often done by a hematologist and is a blood test.

About Dr. Hoyle

Dr. Hoyle has been practicing Phlebology (Specialty with Vein Disorders) for 15 years. He was the first physician in Orange County to perform endovenous laser ablations. He was also the first doctor to perform micro phlebectomy and the first to utilize tumescent anesthesia for vein procedures. He has been an invited lecturer at Chapman University and appeared twice on the TV show “Health Matters”. He has also been interviewed on the radio show “Straight Talk MD”. Dr. Hoyle is an expert reviewer for the Medical Board of California and served for several years as a consultant at the VA hospital in Long Beach. Dr. Hoyle was among the first 200 doctors in the U.S. to pass the exam to obtain Certification by the American Board of Lymphatic and Venous Medicine. He has also passed the examination for Registered Physician in Vascular Interpretation (R.P.V.I.) by the American Registry for Diagnostic Medical Sonography.

A Canadian transplant from Toronto, with a medical degree from the University of Western Ontario, Bruce Hoyle has lived and worked in Orange County, California for most of his career. He holds an MBA degree from the University of California, Irvine. Dr. Hoyle is the chairman of the ACP's Coding and Reimbursement Committee and serves on the American Medical Association's CPT Advisory Panel. He has also served on the board of the ACP Foundation.

  • In 2012 Dr. Hoyle was elected a “Fellow” of the American College of Phlebology.
  • In 2013 Dr. Hoyle wrote a chapter revision in the American College of Phlebology’s textbook “Fundamentals of Phlebology.”
  • In 2013 he completed a white paper for the American College of Phlebology, “Guidelines for Treatment of Superficial Venous Disease”. This document was produced mainly for the insurance industry in the hope of creating more uniformity to medical necessity for treatment of superficial venous disease.
  • In 2015 he spoke to Medicare Administrators for 12 states regarding coverage of the Clarivein device (mechanochemical ablation).
  • Recently he agreed to serve as an advisor to the AMA CPT editorial panel.


 

Read more

Dr. Hoyle has been practicing Phlebology (Specialty with Vein Disorders) for 15 years. He was the first physician in Orange County to perform endovenous laser ablations. He was also the first doctor to perform micro phlebectomy and the first to utilize tumescent anesthesia for vein procedures. He has been an invited lecturer at Chapman University and appeared twice on the TV show “Health Matters”. He has also been interviewed on the radio show “Straight Talk MD”. Dr. Hoyle is an expert reviewer for the Medical Board of California and served for several years as a consultant at the VA hospital in Long Beach. Dr. Hoyle was among the first 200 doctors in the U.S. to pass the exam to obtain Certification by the American Board of Lymphatic and Venous Medicine. He has also passed the examination for Registered Physician in Vascular Interpretation (R.P.V.I.) by the American Registry for Diagnostic Medical Sonography.

A Canadian transplant from Toronto, with a medical degree from the University of Western Ontario, Bruce Hoyle has lived and worked in Orange County, California for most of his career. He holds an MBA degree from the University of California, Irvine. Dr. Hoyle is the chairman of the ACP's Coding and Reimbursement Committee and serves on the American Medical Association's CPT Advisory Panel. He has also served on the board of the ACP Foundation.


 


Read less
Additional Veins That May Need Treatment
  • Enlarged hand veins are normal veins that become more visible as the skin relaxes and thins with age.  They are not considered to be diseased as are protruding varicose veins in the legs. They can however, be easily injured and unsightly as the skin becomes more fragile. A combination of ambulatory phlebectomy and sclerotherapy may be necessary to treat unwanted hand veins.

  • The two types of facial veins most often treated are the smaller spider veins and larger reticular veins. Spider veins usually appear as fine irregular red lines on the nose, cheeks and the side of the face. The larger reticular veins appear greenish blue in color and can be 2-3 mm in diameter. They are most often found along the cheekbone under the eye and at the temple areas. Reticular veins and large spider veins are best treated by ambulatory phlebectomy or sclerotherapy, while smaller spider veins are usually treated easily with LASER.

Exceptional Training and a Pioneer in his field

Dr. Hoyle has traveled both nationally and abroad to several important centers to acquire the exceptional skill needed for the treatment of vein disorders. Dr. Hoyle has practiced and studied with some of the leaders in the laser vein surgery field in advanced centers of La Jolla, Phoenix, and Toronto. In 2004, Dr. Hoyle traveled to Lausanne to visit Dr. Albert Ramelet who is one of the world's recognized pioneers in the modern treatment of varicose veins. Dr. Ramelet has written a major reference textbook on the treatment of varicose veins and designed some surgical instruments used today.

Dr. Hoyle has practiced medicine in Orange County for over 25 years. He was the first physician in Orange County to perform an endovenous laser ablation. He is one of a few doctors in Southern California doing ambulatory micro-phlebectomy. In 2007 Dr. Hoyle was one of a few doctors from around the country who participated in a seminar held in Houston, which was focused on the laser treatment of perforator veins and subsequently was one of first doctors in Orange County to use a laser to treat incompetent perforator vein Dr. Hoyle is a member of the American College of Phlebology and is board certified by the American Board of Phlebology. He is also a member of ARDMS with the credential RPVI® – Registered Physician in Vascular Interpretation.

Read more
Advanced Technology and Techniques
  • Advanced Vein Center is a leading vein treatment center in Southern California specializing exclusively in the diagnosis and treatment of venous disorders including spider veins and varicose veins.

    Dr. Hoyle has been practicing Phlebology (the treatment of vein disorders) for over 10 years. The Advanced Vein Center and Dr. Hoyle pioneered the use of Endovenous Laser Ablation and Microphlebectomy in Orange County. All of our procedures are done in the office on an outpatient basis with the use of a local anesthetic and a mild sedative if needed. The patient is awake throughout the procedure and able to resume normal activity almost immediately.

  • We perform diagnostic ultrasound exams in our office using a state of the art ultrasound equipment dedicated explicitly to vein evaluations. We do not refer our patients to an outside imaging center or hospital for ultrasound evaluation. We have found too often that outside sonographers are not properly trained in evaluating the superficial veins. Dr. Hoyle personally performs or supervises all ultrasound evaluations.

    Diagnostic Ultrasound is now considered the standard of care for evaluating vein disorders in the lower legs. Treatment failures for spiders and bulging veins are often due to overlooking problems with deeper veins in the legs. Only ultrasound can see these problems. If the test is ordered and performed at a hospital or outpatient diagnostic center, it is often done by a technologist who has had minimal or no training in evaluating the superficial veins


  •  

    There has been a rapid change in the last decade in the field of vein treatment technology. Here are some of the technologies used in our office. The Veinlite is helpful for visualizing reticular veins. These are dilated bluish intradermal veins 1-3 mm in size.

                      

  • Spider veins (telangectasias) can be hard to see with the naked eye during treatment. The Syris headlight uses a double polarized filter along with a halogen light source and lens to remove skin glare and magnify the spider vein.

                                      

  • Endovenous laser treatment has continued to evolve over the last decade. The original lasers were in the 800 to 100 nm wavelength and targeted hemoglobin part of blood. The newest lasers are in the 1400 nm range and target the water part of blood. This allows treatment with 1/3 of the energy previously needed and results in none to minimal bruising and discomfort. Dr. Hoyle had the first Thermalite 1470 laser in California.

Advanced Vein Center is pleased to offer patients and clients flexible payment options including:

Most PPO insurances accepted

Medicare

Please contact the office for complete coverage details and questions.

Care Credit Financing Program Available

Credit Cards Accepted: Visa, Master Card and Discover

Aetna PPO
Anthem Blue Cross Blue Shield
Anthem Blue Cross of California
Blue Cross Blue Shield of California PPO
Blue Cross PPO
Blue Shield of California PPO
Blue Shield PPO
BlueChoice PPO
Capital Health Plan
CareCredit
CenCal Health
Cigna PPO
Covered California
Health Alliance PPO
Health First
Health Net California Large Group PPO

Varicose and Spider Veins Podcast

Dr. Bruce Hoyle was recently featured on the Straight Talk MD podcast with Frank Sweeny. The show covered everything you ever wanted to know about varicose veins, spider veins, and chronic venous insufficiency.

Please click on the Soundcloud or Straight Talk MD Image to listen!

Read more
Location
Advanced Vein Center
1120 West La Veta Avenue, Suite 830
Orange, CA 92868
Phone: 714-988-6124
Office Hours

Get in touch

Info@ocveinmd.com
714-988-6124

Bruce Hoyle, M.D.
1120 West La Veta Avenue
Suite 830
Orange, CA 92868