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[Hypercoagulable ulcers. Apropos of a recent case].

P Blanchemaison1, P Griton, M Cloarec

  • 1Service de Médecine Interne et Pathologie Vasculaire, Hôpital Tenon, Paris.

Phlebologie
|October 1, 1987
PubMed
Summary

A chronic, painful varicose ulcer unresponsive to standard treatments may indicate hypercoagulability. Prolonged heparin treatment can effectively manage these hypercoagulable ulcers, normalizing thrombodynamic potential and enabling healing.

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[The 1st clinical signs of venous insufficiency in children].

Phlebologie·1992

Area of Science:

  • Vascular Medicine
  • Hematology

Background:

  • Chronic venous ulcers present a significant clinical challenge, often proving resistant to conventional therapies.
  • Identifying underlying systemic conditions is crucial for effective treatment of refractory ulcers.

Observation:

  • A 38-year-old male cafe waiter presented with a 17-year history of a chronic, painful left sub-malleolar varicose ulcer.
  • The ulcer was refractory to extensive local, surgical, and hospital-based treatments, leading to professional invalidity.

Findings:

  • Absence of arterial, deep venous, or lymphatic compromise suggested a systemic etiology.
  • The ulcer was classified as hypercoagulable, indicated by biological disturbances and a high index of potential thrombodynamic (I.P.T.).
  • Heparin treatment normalized the I.P.T. and facilitated successful complementary surgical grafting.

Implications:

  • Refractory vascular ulcers warrant investigation for underlying hypercoagulability.
  • Prolonged, carefully monitored heparin therapy can be a successful treatment for hypercoagulable ulcers.
  • Hospitalization for continuous heparinization and biological monitoring optimizes outcomes for these complex cases.

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