Arterial vs. Venous Insufficiency

Written By Center for Vein Restoration
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Venous and arterial insufficiency can both lead to open sores on the leg, but the cause for each disorder is very different and demands different treatment.

Although arterial and venous insufficiency share many of the same characteristics and symptoms, the two conditions are actually quite different. Venous insufficiency refers to a breakdown in the flow of blood in our veins, while arterial insufficiency stems from poor circulation in the arteries.

Left untreated, both conditions may lead to slow-healing wounds on the leg. If you have a sore on your leg or ankle that hasn’t healed in weeks, you should immediately see a vascular specialist to diagnose the disorder and prescribe treatment. By reviewing your symptoms, the doctor will determine whether your problem is due to an arterial or venous disorder.

Venous Vs. Arterial Disorders

Blood moves throughout our bodies via a system of arteries and veins. The arteries pump blood from the heart to the rest of the body’s organs and tissues. Veins return blood to the heart from the extremities. 

To work against the force of gravity, veins contain small valves that close up and nudge the blood upward. When those valves malfunction, blood collects in the vein, creating pressure that eventually cuts off the flow of oxygen to the skin. As this pressure builds, an ulcer breaks through the skin.

Venous ulcers sometimes occur alongside varicose veins, which are also caused by swollen veins. These shallow, red wounds typically emerge on the inner part of the ankle or just below the knee. Covered by a thin layer of yellow tissue, venous ulcers are often accompanied by swelling, discolored and tight skin, and a discharge.

Treatment for venous ulcers centers on proper wound care, antibiotics to clear up an infection if present, and compression therapy to improve blood flow. If the wound is painful, you can take pain reducers. Elevating your legs also encourages blood flow, as do exercises that strengthen the calf muscles.

Arterial insufficiency arises when the arteries in the lower leg and foot become blocked by fatty deposits. The resulting disease, atherosclerosis, is most often caused by smoking, high blood pressure, and diabetes. Much like venous insufficiency, oxygen and nutrients cannot replenish the skin and tissue of the extremities and open ulcers develop.

Wounds associated with arterial blockages usually appear on the lateral side of the ankles, feet, heels, and toes. A gray base covers the ulcer, while the borders take on a “punched out” appearance. Your feet may feel cold even in a warm environment, and the skin on the feet may look white, bluish, or shiny. 

You may experience pain and cramping when you walk, which subsides during rest. The pain increases at night, but you may find relief when you put your legs over the side of the bed.

If the underlying cause is clogged arteries, a vein specialist might recommend a surgical procedure, such as angioplasty, to remove the blockage so blood can flow unimpeded again. Antibiotics and maintaining a dry wound aid in healing, as well, but are not a cure for an arterial-related ulcer.

Preventing Arterial and Venous Wounds

If you’re at risk for a leg ulcer due to varicose veins or notice one already forming on your leg, the vein specialists at the Center for Vein Restoration will determine the best course of treatment. We can also offer prevention tips, such as staying active and managing chronic conditions, including diabetes and high blood pressure. If you have diabetes, we can provide tips to keep your feet healthy and free of wounds. Contact us for an appointment today.


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