Venous Endovascular Invasive Solutions (The VEINS)

The #1 Vein Center in the Tri-State Area

The VEINS LogoAmerican Board of Vascular Medicine certified physician Andrey Espinoza MD established The VEINS at Advanced Heart and Vascular Institute of Hunterdon to provide a facility for the needs of patients afflicted with all forms of venous vascular disease. At a very fast pace, this center has grown into a multi-specialty practice that provides the most cutting-edge treatment methods for various vascular conditions.

We are conveniently located in Flemington, NJ in a state of the art office.

Our Vein Specialists are the top providers of diagnosing your vein condition and ensuring all patients receive the best medical advice, treatment and follow-up care. We will go the extra mile to ensure that our patients achieve the best results possible. Healthy, beautiful and painless legs and skin is possible with a variety of treatment options for patients of all ages. Dr. Espinoza, will design a treatment plan that will get you the results you deserve.

The Latest Technology Means the Greatest Results

We offer our patients’ top-tier, state-of-the-art noninvasive and minimally invasive treatments for a variety of vascular diseases. Our access to the most cutting-edge technologies to treat vein conditions allows flexibility and tailoring of your treatment plan to maximize outcomes and minimize recovery time. We are also highly rated for Sclerotherapy and VenaSeal treatments.

Vein Disease

What Causes Vein Disease?

Venous insufficiency occurs when a value fails to function as designed. Sometimes the valves become damaged or diseased causing blood to flow backwards (reflux) or causing blood to pool in your legs (stasis). This condition can lead to very pain and discomforting symptoms such as pain, aching, throbbing, fatigue, skin changes, lesions, heaviness, itching/cramping and varicose veins. If vein disease is left untreated, symptoms can worsen and lead to chronic venous insufficiency. According to the ACP, over 40 million Americans both men and women, will develop a form of vein disease at one point in their lives.

Early symptoms may seem minor. However, if left untreated they can become more serious and even life threatening. It is important to be aware of symptoms and seek medical advice at the earliest sign of a problem.

Vascular Conditions

Vascular ConditionsVascular conditions affect the veins and arteries in your body, which conduct oxygen to every living cell. Veins and arteries are like highways. When there is a road block or traffic jam, trouble ensues. In most cases, vascular conditions are treatable, often without surgery.

Chronic Venous Insufficiency

Venous insufficiency is a catch-all phrase applied to a number of disorders that affect the veins and valves in the veins. These disorders interfere with blood flow, causing pools and leading to a variety of symptoms including spider veins, varicose veins, and other changes in the skin. There are several symptoms to look out for and can include:

  • Edema
  • Heaviness
  • Pain or cramps in the legs
  • Restlessness
  • Dermatitis
  • Spider veins and varicose veins
  • Venous leg ulcer

Chronic Venous Insufficiency is a progressive condition and symptoms do increase in severity as the condition goes on.

If you think you may have a venous insufficiency condition call us today to schedule a consultation.

Spider Veins (Telangiectasis)

Spider veins are small veins varying in red, purple, and blue vessels that twist and turn. This type of vein is easily visible through the skin and commonly found on the face and legs. Similar to their larger counterparts (varicose), valve failure of these smaller veins cause blood to flow backward to the surface. This process is called reflux – where the veins become larger and visible. Spider veins develop in persons who inherit the condition from their parents. Although Spider Veins can cause discomfort they do not lead to more serious complications associated with varicose veins. If spider veins are exposed to the sun, further collagen tissue damage can occur.

What causes spider veins?

Spider veins are predominantly caused by genetic factors. There is a host of factors that can cause spider veins including:

  • Aging
  • Obesity
  • Sun exposure
  • Hormonal changes (puberty, pregnancy, menopause)
  • Sedentary

Varicose Veins

Varicose veins are large, raised, swollen blood vessels that twist and turn. Typically, these veins develop in the legs and are visible through the skin. These veins are an inherited condition and develop either alone or alongside of spider veins. These bulging veins most commonly arise from internal valve failure. When the internal valve loses its seal over time, blood begins to flow backwards also known as reflux. This causes the veins to protrude to the surface, creating unsightly and painful symptoms. Symptoms could include aching, restlessness, itching and heaviness. Varicose veins if left untreated, can lead to complications that include ulcers, dermatitis, pigmentation, or thrombosis.

What causes Varicose veins?

Varicose veins are mainly a genetic inheritance, but lifestyle choices also play significant factors. Here is what can cause Varicose Veins:

  • Aging
  • Obesity
  • Sun exposure
  • Hormonal changes
  • Sedentary lifestyle
  • Pregnancy and Varicose Veins

Many women first develop varicose veins during pregnancy. During pregnancy, your blood volume increases, while the rate at which blood flows from your legs to your pelvis decreases. Increased progestin levels during pregnancy can result in dilated or opened veins. In addition, as a woman’s uterus grows, it puts pressure on the inferior vena cava (large vein on the right side of the body that carries blood. Generally, varicose veins usually diminish 3 months to a year after giving birth.




Asclera is the only sclerosant with a specific FDA-approved indication to treat spider and reticular veins. This agent is polidocanol. A highly predictable and effective agent that provides uniform and consistent results.


VARITHENA (polidocanol injectable foam) is a sclerosing agent indicated for the treatment of incompetent great saphenous veins, accessory saphenous veins, and visible varicosities of the great saphenous vein (GSV) system above and below the knee. VARITHENA improves the symptoms of superficial venous incompetence and the appearance of visible varicosities.

Radiofrequency Ablation

This procedure involves insertion of a small catheter with a heat coil at the tip which is then directly inserted into the affected vein with the guidance of ultrasound technology. The catheter will deliver radiofrequency heat energy into the vein walls which will close the vein and stop blood flow to the various veins. The catheter is then safely removed and a bandage will be applied to the insertion site. Prior to the procedure, patients will be administered a local anesthetic to ensure comfort throughout the procedure.

Downtime is minimal with most patients being able to return to regular activities shortly after. To ensure healthy blood flow and healing, the patient will wear compression stockings for two weeks after the removal of bandages.
After the procedure patients can expect symptoms to improve dramatically within a few days. The discomfort previously experienced due to varicose veins will be gone.


As featured on “The Dr. Oz Show,” the VenaSeal closure system is the most recent innovation in the treatment of varicose veins that is minimally invasive and very safe. This procedure is the use of a medical glue known as VenaSeal to shut the main defective vein. Once the vein is glued shut, it will undergo a hardening process and gradually be absorbed by the body. VenaSeal is the only non-tumecent, non-thermal, non-sclerosant procedure that uses a proprietary medical adhesive delivered endo-venously to close the vein.

Ambulatory Phlebectomy

Ambulatory phlebectomy is performed for the removal of large or medium sized superficial varicose veins. Miniscule linear incisions or punch holes are made on the surface of the skin to allow easy removal of vein. Since the incisions are so small, stitches are not required leaving a cosmetically satisfying result. The patient may experience minimal pain during the procedure which can be relieved by a mild sedation and local anesthesia.

Although the large vein is being removed, there is no effect on the blood flow or circulation on the leg. In fact, blood flow will be more efficient while the bulge in the leg is removed.

Downtime is minimal with limited restrictions – many patients may be able to return to work the same day.

Our Team

With use of the latest diagnostic and interventional tools, Dr. Andrey Espinoza, Julie Cardoso RDCS RVT will diagnose your vein problem and design a treatment plan custom to your vein condition. The first step would be to come in for a free consultation where we will make an accurate assessment of the cause of your vein issue. In some cases, an venous ultrasound may be required in order to fully assess your vein condition and help you understand the entire picture of the condition.

Andrey Espinoza, MD, FACC, FSCAI

Dr. Andrey Espinoza

Dr. Andrey Espinoza

A repeat New Jersey Monthly Top Doctor and Castle Connelly honoree, Dr. Andrey Espinoza has an ongoing commitment to bring the most cutting-edge cardiovascular techniques to his practice, the Advanced Heart and Vascular Institute of Hunterdon. Recently, for example, he created an Advanced Clinical Research and Therapies Division, which will incorporate clinical studies and heart failure management, as well as a vein and vascular program, in order to integrate overlapping disease states into a cohesive and targeted approach to patient care.

Triple board certified in cardiovascular disease, interventional cardiology and endovascular medicine, Dr. Espinoza prides himself on leveraging his expertise in these areas while delivering compassionate, patient-oriented care.

“Our slogan is ‘Where patients come first,’” Dr. Espinoza says. “And we truly strive for that. Our patients see a doctor each and every time when they come to the office. Maintaining the doctor-patient relationship in the current health care environment is more vital than ever. The goal is to blend old-school doctoring with evolving technological advancements.”

Dr. Espinoza is a manuscript reviewer for the journal Catheterization and Cardiac Interventions, and serves on the editorial advisory board of Cardiac Interventions Today. He is also a member of the American College of Cardiology’s Peripheral Vascular Disease Section, member of the American College of Phlebology and Society of Cardiovascular Angiography and Intervention’s Carotid Committee.


  • Hunterdon Medical Center, Flemington
  • Morristown Medical Center.


  • Saba University School of Medicine (MD)
  • Medical College of Pennsylvania/Hahnemann University Hospitals
  • Drexel University College of Medicine (residency, fellowship)

Julie Cardoso, RVT, RPhS, RDCS

Julie Cardoso

Julie Cardoso, RVT, RPhS, RDCS

Director of Non-Invasive Ultrasound Testing. Julie has been passionate about ultrasound for over a decade. After graduating ultrasound diagnostic school in 2005, she went on to obtain three registry credentials as a Registered Diagnostic Cardiac Sonographer, a Registered Vascular Technologist, and a Registered Phlebology Sonographer. Having assisted numerous ultrasound laboratories in echocardiograms and non-invasive vascular testing, she is knowledgeable in all aspects of laboratory function. Through the implementation of her unique, innovative system for laboratory function, Julie Cardoso not only performs ultrasounds but also supports her technical staff via modern education and advance imaging techniques, while simultaneously improving laboratory function and most importantly patient care.

Julie and her husband have four gorgeous children that inspire them every day. She enjoys exercising, hiking, boating, surfing, long walks on the beach, and spending quality time with her family.