Arterial And Venous Ulceration - Episode 30

Venous and arterial ulcer management requires distinct clinical approaches based on etiology and urgency. Arterial ulcers stem from multi-level blockages causing ischemia, necessitating immediate referral and intervention to restore oxygen flow. Conversely, venous ulcers, often involving valve reflux or venous obstruction, allow for a two-to-three-month trial of conservative management before specialist referral. Diagnostic protocols include arterial ultrasound for arterial disease and CT venograms to identify pelvic vein or inferior vena cava obstructions in venous cases. Modern vascular surgery increasingly favors minimally invasive endovascular stenting over traditional open bypass, particularly for non-thrombotic venous lesions, which demonstrate high long-term patency. Dr. Patrik Tosenovsky, Head of Vascular Surgery at Royal Perth Hospital, emphasizes that multidisciplinary teams—incorporating nurses, diabetologists, and vascular surgeons—are essential for managing the complex comorbidities often present in patients with chronic ulceration.