Management of venous ulcers in patients with congenital vascular malformations

Congenital vascular malformations (CVMs) represent complex vascular lesions frequently characterized by inexorable progression and unpredictable clinical course, which can result in substantial morbidity and, in some cases, premature death of these patients. Despite this, CVMs patients are often erroneously diagnosed or inadequately treated due to significant diagnostic and therapeutic challenges, and a prevalent lack of expertise among practitioners. This chapter aims to elucidate details pertinent to the impact of congenital underlying pathophysiology on arterial and venous hemodynamics with its attendant clinical presentations, including ulcerations. The chapter also provides diagnostic protocols and therapeutic algorithms that can be utilized for accurate differential diagnosis, classification, and treatment that can lead to favorable outcomes with acceptable complication rates in this challenging patient population.