At CVD, we treat your symptoms and touch your heart.

CVD provides the most comprehensive care available in the Southwest for your vein disease, from diagnosis through treatment:

  • Only the latest, state-of-the-art technology and procedures available are offered, including Doppler Ultrasound and Venefit
  • Drs. Pester and Bruno are board-certified in Phlebology (vein specialty)
  • Both of our Vein Specialists are also board-certified surgeons, and are experienced in treating all aspects of venous disease, from the simplest cosmetic issues to the most complex medical conditions
  • Insurance Advocate: CVD is your insurance advocate, with our staff spending 30-50% of our time obtaining patient pre-authorizations and medical pre-determination, thus simplifying the process for you

Vein Disease is progressive and will worsen if left untreated. If you are one of the 80 million Americans suffering from a vein disorder, trust the experts at CVD. Common symptoms of vein disease include:

  • Leg pain, aching or cramping
  • Leg swelling at the end of the day
  • Burning or itching of the leg skin
  • Extensive varicose veins on the leg
  • Clusters of small spider veins on the inside of the ankles
  • Brown coloring around the ankles
  • Restless legs when sleeping

The only way to accurately diagnose vein disease is to visit our El Paso vein clinic, Center for Venous Disease, where we can perform diagnostic testing if you are symptomatic, and then recommend your personalized vein treatment plan.

Don't suffer any longerthere has never been a better time to treat your varicose veins or spider veins!

Meet Our Doctors

Thomas L. Pester, MD

Thomas L Pester M.D. is a general surgeon who has 30+ years experience treating varicose veins. Dr. Pester is an active member of the American college of Phlebology, Texas medical Association, and El Paso County medical Society. Dr. Pester is a co-founder of the Center for Venous Disease and treats patients in El Paso Texas. He has treated venous disease with minimally invasive procedures for over nine years. Dr. Pester has served in various medical staff positions including Chief of Staff and numerous department chairmanships. He is also board-certified by the American Board of Quality Assurance and Utilization Review Physicians. He previously served as medical director of the Texas Medical Foundation. He has extensive experience in continuing medical education and has served in both state and national chairmanship positions. Dr. Pester has years of experience in training other physicians in varicose vein procedures, radiofrequency ablation techniques, and sclerotherapy with and without ultrasound guidance.

MD: University of Nebraska College of medicine.

Residency: General Surgery, University of Nebraska Medical Center.

Diplomate: American Board of surgery.

Diplomate: American Board of Phlebology (vein disease)

Felice L. Bruno, MD

Felice L. Bruno, MD is a Cardiovascular and Thoracic Surgeon who has been in practice in the El Paso area, as one of El Pasos leading Heart Surgeons, since 1978. He has been actively involved in treating heart and lung disease, as well as arterial and venous vascular problems for nearly forty years. After completing a two years Fellowship in Cardiovascular Surgery at the Texas Heart Institute, Dr. Bruno was invited by Dr. Denton A. Cooley, Texas Heart Institute Director and the worlds most prominent Cardiovascular Surgeon, to join the Texas Heart Institute surgical staff, where, along with clinical Cardiovascular and Thoracic surgery, he participated in Artificial Heart Research and Cardiac Transplantation. Dr. Bruno later moved to El Paso as co-director of the El Paso Southwestern Cardiovascular Associates practice. During his years of practice in El Paso, together with expanding Cardiovascular Surgical practices and techniques to all El Paso and Las Cruces hospitals, Dr. Bruno has been actively involved with Medical Staff affairs, holding many positions, from Chief of Staff to Cardiovascular Department Chairman. He has been a Member of the Board of Directors with Sierra Medical Center and Sierra Providence Health Network for many years and is a Past President of the El Paso American Heart Association

In early 2010 Dr. Bruno joined the Center for Venous Disease and dedicated his practice exclusively to the treatment of problems and diseases of the venous and lymphatic systems .

MD: University of Torino, Italy " summa cum laude

Fellowship: Cardiovascular Surgery, Texas Heart Institute, Houston, Texas.

Attending Surgeon 1976/1978: Texas Heart Institute, Houston, Texas.

Diplomate of Italian Board of General Surgery.

Diplomate of Italian Board of Cardiovascular Surgery.

Fellow: International College of Surgeons.

Member: D.A. Cooley Cardiovascular Surgical Society.

Member: American College of Phlebology.

Diplomate: American Board of Venous and Lymphatic Medicine.


What are varicose veins?

The term 'varicose veins' is often used to describe everything from smaller, spider veins (red or blue veins on the surface of the skin) up to true varicose veins (swollen, bulging veins with a rope-like appearance). Varicose veins are quite common, with one in three woman and one in five men experience problems. Varicose vein symptoms can include swelling, tiredness, heavy feeling, leg fatigue, leg pain, as well as burning and itching sensations.

What causes varicose veins?

Varicose veins are almost always associated with venous reflux. This occurs when the valves in the leg veins dont work well, and backward blood flow causes pooling in the lower leg. Without treatment, the pressure this creates may increase over time and cause additional varicose veins and symptoms. People with a family history and who are older, obese or are pregnant may be at increased risk of developing varicose veins.

Can varicose veins be prevented?

It is unclear if varicose veins can be prevented, but certain actions may help limit the diseases progression and symptoms. Routine exercise, maintaining a normal weight, avoiding excessively long periods of standing or sitting, and the use of compression stockings may all help alleviate symptoms.

What happens if I don't treat the vein?

If you have underlying venous disease (e.g., venous reflux), the pressure created by backflow of blood and pooling in the lower legs may create a progressive condition that only gets worse with time. This may lead to additional spider veins and varicose veins, and in some cases can lead to swelling and venous ulcers at the lower calf and ankle. Only a trained vein specialist can effectively evaluate your spider veins or varicose veins.

Will my spider veins or varicose veins reoccur, even with treatment?

Sometimes the same factors that helped to cause your first spider veins or varicose veins (e.g., family history, age, obesity, female hormones, etc.) will make you predisposed to develop additional vein conditions. If a specific vein is properly treated, it usually does not recur, but it is possible that other veins may become diseased. This is why it is important that even if you have what appear to be simple, cosmetic spider veins, that you consult a vein specialist who can determine if you have an underlying condition (venous reflux). If you do, and you dont treat the cause of the problem, additional spider veins or varicose veins are likely to develop.

Won't I need that vein?

Procedures like sclerotherapy and Closure act to close down a faulty vein. The vein being closed is dysfunctional and is allowing blood to flow backwards and pool, so leaving it open only makes things worse. The body contains numerous other healthy veins that are still functional and can easily take up the additional flow. Treatment of the faulty veins almost always results in improved blood flow in the overall vein system.

What is the cost of vein treatment?

Procedures like VNUS Closure/Venefit and ambulatory phlebectomy, when shown to be medically necessary, are commonly covered by Medicare and insurance providers. Sclerotherapy for spider veins is generally considered a cosmetic procedure and usually not covered. Consult your local insurance provider to determine your exact eligibility and coverage as well as cost.

Why me?

Heredity is the number one contributing factor causing varicose and spider veins. Women are more likely to suffer from these abnormal leg veins. Up to 50% of American women may be affected. Hormonal factors include puberty, pregnancy, menopause, the use of birth control pills: estrogen and progesterone, affect the disease. Other factors that can accelerate and aggravate the appearance of veins, beyond gravity and age, include leg injury, obesity, lack of exercise, weight fluctuation, constriction and long periods of sitting or standing.

When and how are veins treated?

The most commonly asked questions are: Do veins require treatment and what treatment would be best? At Northwest Vein & Aesthetic Center success in the treatment of varicose and spider veins is due to our comprehensive approach. Without treatment venous disease will slowly progress, and sometime lead to more serious conditions.

After obtaining a history and performing a physical exam, the patient undergoes a noninvasive Doppler ultrasound and color ultrasound imaging to determine areas of venous disease (dilated veins, faulty valves, and area of clot). Based on the above information, an individual treatment plan is formulated and discussed with the patient. Veins that are cosmetically unappealing or cause pain or other symptoms are prime for treatment.