AVLS-AVF Session: Venous Ulcers and Inflammation Pathways

Cardiovascular Links and the Endothelial Glycocalyx

An opening talk reviewed the quality-of-life burden of chronic venous disease and large cohort data linking varicose veins to increased cardiovascular events and all-cause mortality, proposing shared pathophysiology through low and oscillatory shear stress, endothelial dysfunction, and inflammation. A second talk described the endothelial glycocalyx as a protective, permeability-regulating layer that sheds in states such as hypertension, sepsis, and high sodium intake, with venoactive compounds and other agents explored as restorative therapies.

Inflammatory Mechanisms and Registry Findings on Leg Ulcers

A third talk traced how reduced shear stress disrupts mechanotransduction and glycocalyx integrity, triggering leukocyte activation, oxidative stress, and vein wall degradation, with venoactive drugs proposed as a modifiable intervention. A closing national registry analysis of nearly 2,000 venous leg ulcer patients found most had surgically correctable superficial or mixed reflux, yet a substantial share lacked compression at presentation, underscoring gaps in guideline-concordant ulcer care.