The peripheral blood pressure in legs with venous ulcers

Venous ulcers require effective compression treatment which is, however, contra-indicated in cases of arterial insufficiency. In elderly patients with typical venous ulcers the question arises whether they may have concomitant arterial insufficiency. In early studies is was proved that arterial insufficiency in the lower limbs may be diagnosed as a low systolic blood pressure in the great toe as compared with the systolic arm blood pressure. In the present investigation the systolic blood pressure in the great toe was measured in 48 patients with verified venous ulcers. The toe blood pressure and the pressure difference from arm to toe were studied and compared with the corresponding values in normal subjects. 35 patients had no evidence of arterial insufficiency, but in 13 cases signs of concomitant arterial insufficiency was found. The method of measuring the systolic blood pressure in the toes seems to be a simple and reliable method for estimating the degree of arterial insufficiency even in patients with chronic venous disease.