Venous insufficiency is not the cause of leg ulcers in sickle cell disease

H. H. Billett, Y. Patel, S. P. Rivers

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Leg ulcers are a well recognized complication of sickle cell disease that has been attributed to venous insufficiency. We studied 16 patients with sickle cell disease and active ulcers using venous pulse volume recordings and photoplethysmography (Doppler studies). Based on hemodynamic monitoring, all 16 patients exhibited rapid refilling times, findings that Imply venous Insufficiency but are also compatible with high‐output syndrome or arteriovenous shunting. Direct invasive venous pressure measurements of these patients demonstrated normal pressures in all of the four patients tested. A different set of four patients underwent venography, which also failed to demonstrate venous incompetence. We hypothesize that anemia results in an increase in peripheral arteriovenous shunting in the extremities and that this, together with the high‐output syndrome of sickle cell disease, produces plethysmography readings that may be confused with findings observed in venous insufficiency. We conclude that measurements of vascular stasis, as recorded by plethysmography, are usually misinterpreted in sickle cell disease. Normal manometric pressure readings and normal venographic studies suggest that venous insufficiency is not a primary factor in sickle cell leg ulcer formation.

Original languageEnglish (US)
Pages (from-to)133-134
Number of pages2
JournalAmerican Journal of Hematology
Issue number2
StatePublished - Jun 1991


  • anemia
  • ulcer formation
  • venography

ASJC Scopus subject areas

  • Hematology


Dive into the research topics of 'Venous insufficiency is not the cause of leg ulcers in sickle cell disease'. Together they form a unique fingerprint.

Cite this