[Arterial ischemic ulcers].
Arterial ischaemic ulcers develop because of inadequate perfusion leading to local ischaemia in the skin and underlying tissue. The most common cause is peripheral arterial disease, giving rise to symptoms like intermittent claudication, rest pain and gangrene, in addition to local ulceration. Diabetes mellitus increases the risk of ulcer formation; admittedly mainly neuropathic ulcers with a low component of peripheral arterial disease. Yet a combination of neuropathy and ischaemia is common ("neuro-ischaemic ulcer"). A thorough patient history and clinical examination can help discriminate arterial ulcers from venous, pressure, traumatic and vasculitis ulcers. Reduction of ankle systolic pressure and calculated ankle/brachial index, sometimes additional other non-invasive laboratory tests, confirm peripheral arterial disease. The primary treatment of arterial ischaemic ulcer is to increase blood supply to the affected area, primarily by endovascular treatment or open arterial reconstruction. Endovascular treatment (balloon angioplasty) is the method of choice because of graft infection risk in patients with open ulcers. Most arterial ischaemic ulcers will progress to healing if the blood supply is reestablished.
Stranden
Einar
E
Sirkulasjonsfysiologisk avdeling, Kirurgisk klinikk, Aker universitetssykehus HF, 0514 Oslo einar.stranden@medisin.uio.no
Slagsvold
Carl-Erik
CE
D000800:Angioplasty, Balloon; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001158:Arteries; D001273:Atmosphere Exposure Chambers; D001795:Blood Pressure Determination / Q000379:methods; D006801:Humans; D007511:Ischemia / Q000150:complications; D007871:Leg Ulcer / Q000175:diagnosis / Q000209:etiology / Q000473:pathology / Q000628:therapy; D014656:Vascular Surgical Procedures / Q000379:methods; D014689:Venous Insufficiency / Q000150:complications
D000959:Antihypertensive Agents