Arterial Ischemic Ulcer: Understanding Your Diagnosis

Hearing the words “arterial ischemic ulcer” can feel overwhelming, especially if you're unsure what it means or what comes next.

That’s where we come in. 

Our experts at Advanced Vascular Solutions in Melbourne and Sebastian, Florida, take a closer look at what arterial ulcers are, their causes, and how we can help you take control of your treatment and recovery.

Understanding arterial ischemic ulcers

Arterial ulcers form due to ischemia, a medical term for reduced blood flow. When blood can’t reach the extremities, your tissues don’t get the oxygen and nutrients they need. Over time, this can lead to tissue damage, particularly in areas prone to pressure, such as the toes or ankles.

Common causes of decreased blood flow include:

• Atherosclerosis (plaque buildup in the arteries)
• Smoking
• Diabetes
• High blood pressure
• High cholesterol
• Sedentary lifestyle or obesity
• Age and family history

If you have one or more of these risk factors, your body may have a harder time healing even minor scrapes or blisters, which can increase your risk of developing ulcers.

These ulcers are often associated with peripheral artery disease (PAD), a condition in which arteries in the legs become narrowed or clogged with plaque.

Recognizing arterial ischemic ulcers

Arterial ulcers typically have a few key characteristics:

• Punched-out appearance with clear, well-defined edges
• Little to no bleeding
• The skin around the ulcer may be shiny, tight, or hairless
• Cool or cold skin on the feet or legs
• Severe pain, especially at night or when you elevate your legs
• Weak or absent pulses in the affected limb

If you notice any of these signs, see one of our specialists right away. The longer an arterial ulcer goes untreated, the higher the risk of infection and complications.

Diagnosing and treating arterial ischemic ulcers

To diagnose an arterial ischemic ulcer, we need to perform a physical exam and ask detailed questions about your symptoms, medical history, and lifestyle. From there, we may order other tests, such as:

• An ankle-brachial index (ABI) test to compare blood pressure in your arms and legs
• Doppler ultrasound to assess blood flow in your arteries
• Angiography or imaging studies to pinpoint blockages
• Wound cultures, if we suspect an infection

A proper diagnosis is crucial for selecting the appropriate treatment plan and preventing future ulcers from developing.

Treating an arterial ischemic ulcer typically involves two key objectives: improving blood flow and promoting wound healing.

Restoring circulation

To reestablish healthy blood flow, we typically begin with lifestyle changes, such as quitting smoking and managing diabetes. We can also prescribe medications to improve circulation or thin the blood

In some cases, we resort to procedures such as angioplasty or stenting to open narrowed arteries and improve circulation. We recommend bypass surgery in cases that are more severe. 

Wound care

Wound care is one of the most important pieces of the puzzle. We offer two main types of wound care: wound vac and skin grafts. 

Wound vac creates negative pressure around the wound to improve circulation and simultaneously remove debris and fluid. 

Skin grafts use healthy skin tissue to repair wounds that are too big to heal on their own. 

Preventing future ulcers

Once you've had an arterial ulcer, your risk of developing another goes up. But the right prevention plan can make a big difference. 

We strongly encourage you to stay active (within your limits). Even regular walking helps improve circulation. If you need help creating an ulcer-prevention exercise plan, don’t hesitate to reach out. 

Other healthy habits that can keep ulcers at bay include:

• Controlling chronic conditions like diabetes and high blood pressure
• Inspecting your feet and legs daily for cuts, blisters, or color changes
• Avoiding tight shoes and socks that restrict circulation
• Keeping skin moisturized (but avoid applying lotion directly to open wounds)
• Following up regularly with your Advanced Vascular Solutions provider

An arterial ischemic ulcer isn’t something to ignore, but it also isn’t something you have to face alone. With prompt diagnosis, expert care, and a personalized plan, healing is possible, and so is preventing future ulcers.

If you or a loved one has been diagnosed with an arterial ulcer, now’s the time to take action.  Request an appointment over the phone today or send us a message here on our website. We’re proud to serve patients in and around Indian River and Brevard counties.