Vascular Ulcers
A leg or foot wound that won't heal is almost always a circulation problem. At MVM, we identify whether the cause is arterial, venous, or both - and treat the underlying vascular disease so wounds can finally close.
What are vascular ulcers?
Vascular ulcers are wounds on the lower leg or foot that result from problems with circulation - either arterial blood flow in, venous blood flow out, or both. They are different from injuries or pressure sores; the key feature is that they don't heal in a normal timeframe because the underlying circulation cannot support healing.
Venous ulcers are the most common. They form near the inner ankle when failing leg vein valves let blood pool and pressure rise in the lower-leg tissues. Arterial ulcers form on the toes, foot, or shin when narrowed arteries can't deliver enough blood. Diabetic foot ulcers often combine arterial disease with nerve damage and pressure points. Each type looks different and demands different treatment.
The single most important step is figuring out which kind of vascular problem is driving the wound. Wound dressings, debridement, and topical care all matter - but they won't get a wound to close until the underlying circulation is addressed. With the right combination of vascular intervention and wound care, most vascular ulcers can be healed.
How MVM treats vascular ulcers.
Patients and referring physicians choose MVM for vascular ulcers because wound care alone won't heal a wound caused by a circulation problem - and identifying that problem is what we do.
- Same-week consults. New patients with non-healing wounds are typically seen within 5 business days. Limb-threatening wounds are triaged for same-day or next-day evaluation.
- Complete vascular workup in one visit. Ankle-Brachial Index, toe pressures, arterial Doppler, and venous duplex performed in our office - most patients leave with a diagnosis.
- Arterial revascularization when needed. Endovascular angioplasty, atherectomy, and stenting at our Kendall Procedural Suite for arterial wounds.
- Endovenous treatment for venous ulcers. Radiofrequency ablation, laser ablation, and other modalities to fix the underlying vein problem.
- Coordinated wound care. Close partnerships with podiatry and wound-care specialists across South Florida - we don't treat wounds in isolation.
- One specialist, full continuum. The doctor who diagnoses you also performs your procedures and stays involved until the wound is closed.
Schedule a vascular ulcer consultation.
Most patients are seen within a week. Bring any prior vascular imaging, your medication list, photos of the wound, and a note about how long it's been present.
Schedule a consultationSend us a vascular ulcer referral.
Same-week consults for non-healing leg or foot wounds; same-day for limb-threatening cases. Coordinated care with wound-care and podiatry teams. Closed-loop reporting back to your office within 48 hours.
Referral processCommon vascular ulcer symptoms.
Symptoms vary based on whether the wound is arterial, venous, or mixed. The pattern is often the clue to the underlying cause.
- A wound that hasn't healed in 4 weeks or more
- Venous ulcer signs - wound near the inner ankle, irregular border, surrounding skin darkened or hardened, leg swelling
- Arterial ulcer signs - wound on the toes, foot, or shin; pale or "punched-out" appearance; very painful, especially at night
- Diabetic foot ulcer signs - over pressure points on the foot, often painless due to nerve damage
- Drainage, odor, or visible tissue breakdown
- Surrounding skin changes - redness, scaling, weeping
- Pain or coldness in the affected limb
- Recurrent wounds in the same area
Who is most at risk.
- Diabetes - affects both circulation and nerve sensation
- Chronic venous insufficiency or prior DVT
- Peripheral artery disease (PAD)
- Smoking (current or past)
- Obesity and prolonged standing
- Prior leg or foot ulcer - strong predictor of recurrence
- Advanced age
- Chronic kidney disease
How we diagnose vascular ulcers at MVM.
Most patients leave their first visit with a clear diagnosis of the underlying problem - and a treatment plan that addresses both the circulation and the wound.
- Focused history and exam - including wound appearance, location, and full foot inspection
- Ankle-Brachial Index (ABI) and toe pressures - to assess arterial supply
- Arterial Doppler ultrasound - performed in our office
- Venous duplex ultrasound - to identify reflux or post-thrombotic changes
- Wound culture - when infection is suspected
- Advanced imaging - CT angiography or MR angiography when intervention may be needed
Treatment options.
Treatment depends on the underlying cause - and almost always combines vascular intervention with structured wound care. The goal is durable healing, not just a temporary close.
For venous ulcers
Venous ulcers respond to a combination of compression therapy, treatment of the underlying refluxing veins, and structured wound care. Endovenous closure of the refluxing saphenous vein is often a turning point - many ulcers that have been open for months heal within weeks once vein reflux is treated. Compression stockings or wraps are essential during healing and for long-term prevention of recurrence.
For arterial ulcers
Arterial ulcers won't heal until blood flow is restored. At our Kendall Procedural Suite, we offer:
- Balloon angioplasty - opens narrowed arteries
- Atherectomy - physically removes plaque
- Stenting - holds the artery open when needed
- Pedal-arch reconstruction - opening arteries down into the foot itself when needed
For mixed arterial and venous disease, we treat the arterial side first, then address the venous component.
Coordinated wound care and ongoing follow-up
Vascular treatment runs in parallel with wound dressings, debridement, offloading, and infection management - usually in coordination with a podiatry or wound-care team. We see patients frequently while a wound is open, then space follow-ups out once it's closed and the underlying disease is stable. Recurrence prevention - compression for venous patients, foot care for diabetic patients, ongoing surveillance for arterial patients - is part of the long-term plan.
When to see a vascular specialist.
- A wound on the leg or foot that hasn't healed in 4 weeks
- A recurrent ulcer in the same area
- Sudden worsening of an existing wound
- A new ulcer in a patient with diabetes, PAD, or vein disease
- A recommendation for amputation - please get a second opinion before scheduling
If a wound becomes warm, red, swollen, or starts draining heavily - or if you develop fever along with a leg wound - call our office or go to the nearest emergency room. Infected vascular ulcers can become limb-threatening quickly.
Vascular ulcer FAQs.
Why won't my wound heal?
Wounds on the lower leg or foot need adequate arterial blood flow in, adequate venous return out, intact nerve function, and the right local wound environment. When any of these is missing, wounds stall. Identifying the missing piece is the key to healing.
How long does a vascular ulcer take to heal?
It depends on the size and cause. After the underlying vascular problem is addressed, most ulcers improve within weeks and close within a few months. Some larger or longstanding wounds take longer, and a small percentage need additional procedures.
Is treatment of the underlying vein or artery covered by insurance?
Endovascular and endovenous treatments for a documented vascular wound are typically covered by insurance because they're medically necessary. We help work through the documentation at the consultation.
Will my ulcer come back?
Recurrence risk depends on the cause and how well it's managed long-term. Venous patients need compression and ongoing care; arterial patients need risk-factor management and surveillance; diabetic patients need careful foot care. With the right long-term plan, recurrence rates drop substantially.
I was told my limb may need amputation because of a wound. Should I get a second opinion?
Yes. A meaningful percentage of patients told they need amputation are candidates for limb-saving revascularization and wound healing. We see second-opinion referrals quickly and review imaging directly. Tell our team it's a CLI or amputation question when you call.
Schedule a vascular ulcer consultation.
Most new patients are seen within a week. Bring any prior vascular imaging, the medication list, photos of the wound, and a note about how long it's been present - we'll do the rest.