2018 Volume 27 Issue 2 Pages 149-153
Treatment of venous stasis ulcers includes improvement of venous hypertension and wound management of the ulcer. Herein, we report on a case of multiple relapses of a skin ulcer on the dorsum of the foot. The patient was diagnosed with a plantar arteriovenous fistula and was successfully treated with coil embolization and vacuum-assisted closure (VAC) therapy. A 56-year-old woman with a history of plantar injury in early childhood had developed multiple relapses of an ulcer on the dorsum of the foot over the past 25 years. The patient was referred to our hospital for treatment of the refractory ulcer. Venous ultrasonography showed dilatation of the posterior tibial vein and an increase in venous flow velocity. Lower-extremity computed tomography angiography showed a plantar arteriovenous fistula. The patient was diagnosed with a venous stasis ulcer due to a plantar arteriovenous fistula and underwent coil embolization. After the surgery, the ulcer was managed with combined VAC therapy. No relapse has been observed since the surgery. Our results suggest that coil embolization for the treatment of fistula and VAC therapy for wound healing are very effective in patients with refractory skin ulcers induced by a plantar arteriovenous fistula.
