Venous Ulcers

  • Open sores on the legs caused by chronic venous insufficiency (CVI), which occurs when leg veins do not work properly in sending blood back to your heart. CVI causes blood to "back up."
  • Vein ulcers can be considered as an advanced stage of chronic venous insufficiency and can appear in patients with varicose veins and as consequence of clots. The ulcer, per se, is caused by a network of varicose veins with the onset of an inflammatory reaction that is responsible for the initial skin injury and development into the ulcer. The same process causes the typical leathery, red skin of patients with advanced venous disease.

Symptoms

  • Leg pain, swelling, itching, tingling, or cramping
  • Dark red, purple, or brown skin that feels hard to the touch
  • Shallow sores with a red base, sometimes covered by yellow tissue
  • A sore with unevenly shaped borders
  • Shiny, tight, warm, or discolored skin around a sore

Risks factors for vein ulcers

  • Varicose veins
  • History of blood clots, especially in the legs
  • Age (vein ulcers typically affect older adults)
  • Gender (women are more likely than men to develop vein ulcers)
  • Being tall
  • Being overweight
  • Pregnancy
  • Family history
  • Standing or sitting for long periods of time

Diagnosis

  • Vein ulcers can be diagnosed by a physical exam.
  • Your doctor should order an ultrasound or other tests to check for CVI (chronic venous insufficiency), which causes vein ulcers.

Treatment for vein ulcers

Medical treatments

  • Bandages and/or medicated dressings to help sores heal
  • Compression stockings and garments
  • Inflatable boots (intermittent compression therapy)

Surgical treatments

  • Venous ablation, a catheter-based outpatient procedure that uses heat (via radiofrequency or laser technology) to close and seal a vein.
  • Sclerotherapy, an outpatient procedure that involves injecting a chemical solution directly into the vein, which stops blood flow and causes the vein to collapse and disappear over time:
    • Conventional liquid sclerotherapy
    • Ultrasound-guided foam sclerotherapy