Venous Ulcer Therapy
Venous ulcers are wounds that form on the ankle and lower leg as a result of poor circulation of the legs. Poor vein circulation is most commonly secondary to a genetic circulation condition referred to as venous reflux disease (or chronic venous insufficiency). This circulation problem that leads to the ulcers can also be caused by blood clots or trauma. Venous reflux disease results in the failure of valves that control blood flow in the legs. When these vein valves fail, the pressure inside the legs and skin becomes abnormally elevated. The resulting venous pressure elevation (i.e. venous hypertension) leads to progressive skin damage of the ankles or feet. The skin damage worsens to the point where the skin forms wounds and ulcers.
Venous ulcers are very common and affect approximately 1 % of the U.S. population. They account for over 80% of leg wounds. They most commonly form on the medial or inner side of the ankle. They are most commonly associated with the darkening of the skin in the lower leg and ankle and sometimes the foot. Swelling and pain are commonly associated symptoms as well. The majority of individuals with venous ulcers have a combination of tissue swelling (ie edema) as well as dermatitis of the lower legs and ankles. Sometimes the feet are involved with the swelling and skin changes as well.
Patients with venous ulcers and venous wounds often have varicose veins on the legs and ankles as well. The same process that leads to venous ulcers also leads to the development of varicose veins and leg swelling. Venous wounds are often slow healing or poorly healing due to the underlying circulation problem. The poor circulation leads to diminished oxygen delivery to the skin and diminished nutrients being delivered to the skin. The immune system function in the leg is also adversely affected by this condition. Therefore, venous wounds can persist for months or even years if appropriate therapy is not provided. Venous ulcers can be associated with severe pain, infection, and chronic drainage. Venous ulcers commonly recur after healing if the circulation condition is not repaired. If you have a venous ulcer it is important to seek medical therapy as soon as possible.
Procedures to Cure Venous Ulcers / Ankle Stasis Ulcers
There are many procedures that can be done to help resolve venous ulcers and to keep them from recurring. The therapies are aimed at improving venous circulation, therefore increasing healthy blood flow and improving oxygen delivery to the unhealthy skin and the wound. Underlying venous reflux disease and venous hypertension in the leg should be treated, with the goal of returning venous pressure in the leg back to normal.
Some of the common venous ulcer procedures used to remedy the poor circulation have their effect by lowering the high venous pressure in the leg back to a normal level. Blood is routed out of the unhealthy veins that have broken valves back into healthy veins with functional valves. This can be accomplished with the use of specialized catheters that utilize laser or radiofrequency thermal energy. These venous ulcer therapies are often utilized in conjunction with more conservative methods such as compression stockings in order to achieve the most optimal results.
Additional Methods
Other methods of lowering venous pressure in the legs and therefore allowing the ankle and foot skin to heal include the use of circulation medications. This includes Varithena and VenaSeal. These medications are inserted into defective veins with an IV under ultrasound guidance. These venous ulcer treatments are minimally invasive and allow treatment without surgery.
These vein procedures have a high success rate. Most patients with venous ulcers or wounds can achieve complete healing with the appropriate therapies.
An example of one of our typical patients is photographed below. This is an actual patient treated by Dr. Gotvald at Austin Vein Specialists. All of this patient’s treatments were done in our vein center and no incision or invasive surgery was required. The treatments involved laser and medications administered through IV therapy at our vein center.
Vein Ulcer Specialists
The doctors at our vein centers have over 15 years of experience in treating vein ulcers and are highly skilled in the field of vascular procedures. We are board-certified in Vascular Surgery and Endovascular Procedures and have the highest level of training and experience in the treatment of venous ulcers. You can trust that you are in the best possible hands when you see our vein specialists for your vein circulation problems.
