DOI: 10.1097/01.ASW.0000383218.26406.4b

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PMID: 20729649

Issn Print: 1527-7941

Publication Date: 2010/09/01


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Arterial Ulcer Checklist

Cathy Thomas Hess

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Author Information: cthess@woundcarestrategies.com

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Excerpt

Arterial insufficiency refers to impairment of arterial blood flow leading to tissue ischemia and potentially necrosis. Such impairment can occur acutely (eg, trauma, thrombosis) or chronically (eg, atherosclerosis). Both acute and chronic arterial insufficiency can lead to the formation of lower-extremity ulcers. Arterial insufficiency can occur at any level, from large arteries to arterioles and capillaries. Tissue ischemia that leads to leg ulcers tends to occur more in the setting of large vessel or mixed disease.
The most common cause of arterial ulcers is atherosclerosis. Risk factors for the development of atherosclerosis include age, smoking, diabetes mellitus, hypertension, dyslipidemia, family history, obesity, and sedentary lifestyle. It should be noted that arterial insufficiency might act in concert with other pathological mechanisms leading to tissue necrosis and ulceration. Diabetic foot ulcers, for example, may result from the combination of neuropathy, trauma, and arterial insufficiency. Table 1 lists diseases associated with arterial insufficiency.
A number of conditions are associated with the formation of ulcers that can mimic arterial leg ulcers. A list of these conditions is given in Table 2.
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