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Outcome of venous stasis ulceration when complicated by arterial occlusive disease

W T Bohannon1, R B McLafferty, S T Chaney

  • 1Division Vascular Surgery, Department of Surgery, Southern Illinois University, School of Medicine, Springfield, Illinois 62794, USA.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|September 10, 2002
PubMed

Insights

Patients with venous stasis ulceration (VSU) and severe arterial occlusive disease (AOD) have a rare, serious condition. Healing is uncommon, and mortality is high, even after arterial procedures.

Area of Science:

  • Vascular surgery
  • Wound healing
  • Geriatric medicine

Background:

  • Venous stasis ulceration (VSU) and severe arterial occlusive disease (AOD) are distinct vascular conditions.
  • The combined presence of VSU and AOD presents a complex clinical challenge, particularly in elderly patients.

Purpose of the Study:

  • To investigate the outcomes of patients diagnosed with both VSU and severe AOD.
  • To evaluate the effectiveness of interventions aimed at improving arterial inflow in this patient population.

Main Methods:

  • A retrospective study design was employed.
  • Patient data were identified using ICD-9 codes for VSU and AOD from 1989 to 1999 across two tertiary hospitals.
  • Inclusion criteria required the presence of VSU and an ipsilateral procedure for AOD or major amputation during the same hospitalization.

Main Results:

  • Fourteen patients (15 extremities) with a mean age of 80 years were identified.
  • The mean duration of VSU was 6.4 years, with a mean wound area of 71 cm² and ankle-brachial index of 0.46.
  • Interventions included bypass (60%), interventional procedures (20%), sympathectomy (0.6%), and amputation (13%). Over a mean follow-up of 2.8 years, only 23% of extremities healed, with high mortality.

Conclusions:

  • The combination of VSU and AOD is rare, primarily affecting elderly individuals with comorbidities.
  • Complete healing of venous stasis ulcers is infrequent despite arterial revascularization procedures.
  • High short-term mortality rates were observed in this patient cohort.
Abstract

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