ABSTRACT
Venous ulcer pathophysiology is based on venous hypertension that leads to microcirculatory anomalies and subsequent trophic lesions. The aim of any treatment addressing venous ulcer is to reduce venous hypertension, both to obtain healing and to prevent recurrence. Recurrent cellulitis and recurrent superficial or deep venous thromboses are less common indications. Prospective candidates should undergo a general as well as a detailed venous evaluation. A global test such as ambulatory venous pressure or air plethysmography and contrast computed tomography/magnetic resonance venography studies are useful not only for quantifying venous hypertension, but also for ruling out any functional obstruction in the iliocaval region. Ambulatory venous pressure is influenced by multiple aspects of venous dynamics, including vein wall compliance. A femoral valve is invariably present below the take-off of the profunda femoris vein.
