Chronic vein disease develops in stages, and venous ulcers usually appear during the last and most serious stage. Because of poor circulation, open, shallow wounds form on the lower leg or ankle.

They’re slow to heal and can quickly become infected if not treated. That sometimes leads to lower-limb amputation, especially in diabetics. About 1% of Americans develop these ulcers, which are common in older people, especially women.

At Texas Vascular Institute, now with locations in Dallas and Hurst, Texas, interventional radiologist Dr. Dev Batra and his team have extensive knowledge about the stages of chronic vein disease and the development of venous ulcers.

The team uses state-of-the-art diagnostic tools to pinpoint the underlying cause of your issue and advanced treatment options to restore your vein health. Let’s take a closer look at venous ulcers.

Photo - 0 - A Closer Look at Venous Ulcers

How chronic vein disease progresses

Before we can talk about venous ulcers, we need to discuss the vein problems that cause them. Here are the stages of vein disease in order of progression.

1. Chronic venous insufficiency (CVI)

If a vein wall or one of the vein’s one-way valves becomes damaged, it allows blood headed for the heart to backtrack, pooling around the damaged area and contributing to sluggish flow. That venous insufficiency can easily become chronic if not addressed.

2. Spider veins

These surface-level veins are small, rope-like conduits. When blood pools, they expand, forming thin, spiderweb-like patterns on the skin, primarily on the legs but also on the face.

3. Varicose veins

As sluggish blood flow continues, the larger veins become affected. These varicose veins appear as ropy, colored swellings on the legs. In addition to being a cosmetic problem, they may cause pain, swelling, itchiness, and an aching heaviness in the legs.

4. Edema

Edema refers to the swelling of the leg when overloaded veins leak fluid into the tissues. In addition to causing swelling, the fluid irritates your muscles, which leads to cramping and pain as well as the symptoms of the previous stages. In addition, the skin on your lower legs may start to appear leathery or take on a pale blue or red tint.

5. Venous stasis dermatitis

If you don’t treat the edema, you may develop venous stasis dermatitis — a change in color around your ankles and lower legs that results from the pressure-bursting blood vessels. The areas appear brown or red due to hemosiderin deposits — a breakdown product of hemoglobin. The skin may also turn scaly, shiny, or thickened, and it may scar.

Photo - 0 - A Closer Look at Venous Ulcers
Photo - 0 - A Closer Look at Venous Ulcers

6. Venous ulcers

Venous ulcers occur when the skin changes from the dermatitis aren’t properly treated. Ulcers are easy to identify because they’re:

  • Found on the lower leg or ankle area
  • Surrounded by discolored and/or hardened skin with irregular borders
  • Red at the base
  • Slow to heal

Ulcers can produce large amounts of pus, depending on if they’re infected, and if you touch them, they ooze venous blood. The wound may be relatively painless, but you may experience significant pain from the edema or infection.

How to diagnose venous ulcers

Venous ulcers can easily be diagnosed based on sight. However, if Dr. Batra wants to confirm the diagnosis or discover the underlying cause, he might use vascular ultrasound and ankle-brachial index testing. Most commonly, he can trace the problem to chronic vein disease.

How we treat venous ulcers

At Texas Vascular Institute, our primary goal for treating venous ulcers is to keep them infection-free while also resolving the edema at the site. We may use debridement — scraping of dead tissue and surface contamination to remove it — so the ulcer can heal.

Generally, you’ll only need oral antibiotics if tissue surrounding the ulcer is also infected. We ask you to keep the wound environment moist, changing dressings as infrequently as possible since that removes healthy cells, too.

Most ulcers heal within 3-4 months of treatment, but it varies from person to person.

Dr. Batra also treats ulcers by addressing the underlying vein disease. Techniques include:

  • VenaSeal™: delivers a medical glue to seal the diseased vein shut
  • ClosureFast™: uses radiofrequency (RF) ablation to destroy the diseased vein
  • Ultrasound-guided foam sclerotherapy: injects an irritant into the vein with ultrasound guidance
  • Microphlebectomy: pulls out the entire vein through small incisions

If you’re experiencing any of the symptoms of vein disease, don’t wait until it’s advanced to get help. Call Texas Vascular Institute at 972-646-8346 to schedule a consultation with Dr. Batra at either location or book online with us today.

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Texas Vascular Institute | Dallas, TX

3500 Oak Lawn Ave, #760
Dallas, TX 75219


For Appointments: 972-798-4710
General Inquiries: 972-646-8346

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Texas Vascular Institute | Hurst, TX

809 West Harwood Rd, Suite 101,
Hurst, TX 76054


For Appointments: 972-798-4710
General Inquiries: 972-646-8346

Set Appointment