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[Mixed leg ulcers]

Torsten Willenberg1

  • 1Universitätsklinik für Angiologie, Schweizer Herz- und Gefäßzentrum, Inselspital, Bern. torsten.willenberg@insel.ch

Therapeutische Umschau. Revue Therapeutique
|March 2, 2011
PubMed

Insights

Peripheral arterial disease often coexists with venous leg ulcers, affecting 15-21% of patients. Treatment must address both arterial and venous components for effective healing.

Area of Science:

  • Vascular Surgery
  • Dermatology
  • Wound Healing

Context:

  • Ulcera cruris (leg ulcers) commonly have a venous etiology.
  • A significant percentage (15-21%) of patients with venous leg ulcers also have coexisting peripheral arterial disease.
  • Diagnosing mixed arterial-venous ulcers requires a comprehensive approach including patient history, clinical examination, ankle-brachial index (ABI), and duplex ultrasonography.

Purpose:

  • To highlight the prevalence and diagnostic challenges of mixed arterial-venous leg ulcers.
  • To emphasize the necessity of evaluating and treating the arterial component in these ulcers.
  • To outline current treatment strategies for mixed leg ulcers.

Summary:

  • Mixed arterial-venous leg ulcers necessitate a dual treatment approach.
  • Endovascular revascularization can significantly improve arterial perfusion and promote healing.
  • Compression therapy, potentially with advanced graduated systems, remains crucial for the venous component, alongside consideration for varicose vein ablation.

Impact:

  • Improved diagnostic accuracy for complex leg ulcers.
  • Enhanced treatment outcomes through integrated management of arterial and venous pathologies.
  • Reduced recurrence rates and improved quality of life for patients with mixed leg ulcers.

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