See a Vascular Ulcer Specialist
When you’re ready to see a vascular ulcer specialist, we’re here to help. Dr. Michael Lalezarian is double-board certified Vascular and Interventional Radiologist at ProVascularMD that specializes in vascular ulcers and minimally invasive therapies to treat them. Dr. L is a committed partner in the battle against vascular diseases. He values spending quality physician time with his patients to address their needs and concerns, and assist them on their journey to better health.
“Dr. L changed my life. He’s knowledgeable, caring and my experience with his office staff was as good as it gets. I wish all of my doctor visits felt this way. After a few pregnancies I was having incredibly painful varicose veins that was really wearing on me. The treatment was practically painless and I’m so happy with my results. He’ll be my vascular doctor moving forward.”
Michelle H, February 2022
Types of Vascular Ulcers
Arterial Ulcers
Arterial ulcers are caused by severe atherosclerotic blockages in the arteries, usually in the legs. Arterial ulcers are the end stage of peripheral artery disease (PAD). When severe, insufficient arterial blood flow causes tissue loss in areas of the leg that aren’t sufficiently nourished. Arterial ulcers typically form on ankles, feet, or toes. They may be shallow or deep with sharp “punched out” borders. The wound base is usually gray or yellow with associated gangrene and dry dark scabbing.
Venous Ulcers
Venous ulcers are caused by severely impaired blood flow in the veins of the legs. Venous ulcers are the end stage of chronic venous insufficiency (CVI). Similar to arterial ulcers, insufficient blood flow in the veins causes tissue loss in areas of the leg that aren’t sufficiently nourished. Venous ulcers are typically located in the lower third of the leg in the gaiter region. They are often shallow and irregularly shaped with red granular tissue, fibrinous material, and sometimes calcification.
Arteriovenous (Mixed) Ulcers
Roughly 1 in 4 individuals with vascular ulcers have a mixed type where both peripheral artery disease and chronic venous insufficiency are contributing to vascular ulceration. These cases are referred to as arteriovenous ulcers. Arteriovenous ulcers share risk factors and symptoms of both arterial and venous ulcers, and tend to be associated with older age, lower body mass index, lower mobility, and lower health related quality of life when compared to venous ulcers on their own.
Vascular Ulcer Signs & Symptoms
Arterial Ulcers
Peripheral Artery Disease (PAD)
Ankle, Feet, or Toes
Sharp, Punched Out Borders
Venous Ulcers
Chronic Venous Insufficiency (CVI)
Gaiter Region
Shallow, Irregular Shape
Vascular Ulcer Diagnosis
Diagnosis of vascular ulcers is focused on determining the underlying disease process. When you see a Vascular Specialist about your ulcer, they’ll use a combination of medical history, physical exam, and imaging techniques to determine what’s causing your ulcer and how to best treat it. Get the full workup at ProVascularMD, and get started on your journey to healthy legs.
Physical Exam
Ultrasound
Ultrasound is used to examine flow in the veins and the arteries. In the hands of a skilled ultrasound technician, ultrasound can identify blockages and backups in the vessels of the leg, and can often determine the root cause of vascular ulcers.
Imaging
Vascular Ulcer Treatment
Peripheral Artery Disease (PAD) Treatment
Effective treatment of arterial ulcers often involves addressing the underlying peripheral artery disease. Minimally invasive treatments for peripheral artery disease include angioplasty, stenting, and atherectomy, while surgical treatments include endarterectomy and bypass surgery.
Chronic Venous Insufficiency (CVI) Treatment
Effective treatment of venous ulcers often involves addressing the underlying venous insufficiency. Depending on the location and extent of vein disease, treatments for venous insufficiency may include foam sclerotherapy, vein ablation, stenting, or thrombolysis.
Wound Care
Wound care is a necessary component of treating vascular ulcers. While peripheral artery disease and venous insufficiency treatments address the underlying cause of vascular ulcers, wound care is concerned with keeping ulcers clean, managing the surface of the wound, treating the skin to promote healing.
Be Confident In Your Care Decisions
Vascular Ulcer Education Center
Arterial vs. Venous Ulcers
While destruction of the skin and underlying tissues is a feature of both diseases, arterial ulcers and venous ulcers are clinically different in terms of how they present, what they look like, and what symptoms the affected individual experiences. The appropriate course of treatment for each type of ulcer is also quite distinct, requiring the expertise of a Vascular Specialist to navigate effectively and return the leg to a healthy state. Learn more about the differences between arterial and venous ulcers in this in-depth review of ulcer causes, symptoms, and treatment options.
Amputation Prevention
Limb Salvage
Vascular Wound Care
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