Treatments that close down varicose veins can sometimes help venous leg ulcers heal. Dr. Dev Batra describes the experiences of one of his patients that was living with a venous leg ulcer, and how he used a vein closure procedure to help heal her ulcer.
Venous leg ulcers are the most severe manifestation of chronic venous disease. We recently cared for a 50 year old patient with an open leg ulcer that had been living with severe cramping, pain, and heaviness in both of her legs for nearly 10 years. This is not uncommon - unfortunately, individuals affected by vein problems tend to live with ulcers or other debilitating symptoms of chronic venous disease for several years before finding their way to an effective treatment strategy.
For this patient (and several others with venous leg ulcers), we were able to dramatically improve the health of her legs with modern vein treatment and coordinated care with a wound specialist.
Individuals with more severe stages of chronic venous disease battle a number of symptoms that can make their daily lives difficult. Our patient’s symptoms worsened significantly when standing for long periods of time, which was especially challenging because her work required her to be on her feet for long periods of time. She was frequently unable to finish a day’s work because of the severe pain and swelling in her legs.
Her active ulcer had been present in the gaiter region of her left leg for 4 months and her right leg had undergone pigmentation changes. She had previously experienced ulceration closer to her foot that had healed some time prior to her visit to Dallas Vein Institute. We suspect that a new ulcer had formed because her underlying vein disease had not been addressed.
An ultrasound exam revealed that our patient had clinically significant reflux in her common femoral, greater saphenous vein (GSV), and small saphenous vein (SSV) in both of her legs. She also had many tributaries (branching varicose veins) off of her GSVs and SSVs. These ultrasound results confirmed that our patient was affected by C6 chronic venous disease in her left leg and C4A disease in her right leg according to the CEAP classification system.
Given the extent of our patient’s vein disease, we opted to treat the GSV and SSV in both of her legs with radiofrequency ablation, followed by foam sclerotherapy to take care of the tributaries - effectively shutting down all of her diseased veins. Following treatment, the patient’s symptoms of swelling, heaviness, and pain dramatically improved. Her ulcer healed, and her skin color returned to a normal tone with some visual artifact of the previous ulceration. Our patient has since reported that she is now able to work pain free and her quality of life has majorly improved.
Our patient before (left) and after (right) vein treatment for her venous leg ulcer.
This is not an exceptional case by any means. In our previous article, we provided an in-depth review of the clinical studies that have demonstrated the impact of radiofrequency ablation in the healing of venous leg ulcers and the prevention of ulcer recurrence. Vein treatment is certainly a more proactive approach than the conservative management techniques of traditional wound care, but proactive patients may find that their leg ulcers are directly caused by very treatable vein disease.
About the Author
Dr. Dev Batra, M.D. is a vein specialist and founding partner of Dallas Vein Institute. Holding board certifications in radiology and vascular & interventional radiology, he is well-versed in vein issues and has been voted one of D-Magazine’s best doctors in Dallas for three years running.
This blog post was written with research and editorial assistance from OnChart™.
The Materials available in the Dallas Vein Institute blog are for informational and educational purposes only and are not a substitute for the professional judgment of a health care professional in diagnosing and treating patients.