Stasis ulcers refractory to therapy - Accelerated healing by treatment with clopidogrel +/- dalteparin: A preliminary report

Stasis ulcers are commonly the result of chronic venous insufficiency. We h ave recently assessed 15 patients with stasis ulcers that failed to heal af ter one year of routine wound care. All patients demonstrated a defect in h emostasis, and a biopsy revealed livido vasculitis. Eleven of fifteen patie nts were treated with clopidogrel and dalteparin, and 4 of 15 patients were treated with clopidogrel alone. Thirteen of fifteen patients (86.6%) compl etely healed within three months of starting antithrombotic therapy. Patien ts with stasis ulcers and chronic venous insufficiency who fail to heal wit h routine around care should be subjected to biopsy, a procoagulant defect evaluation, and initiation of clopidogrel and dalteparin therapy if a defec t is found.