Phlebosclerosis with calcification in a patient with advanced venous ulcer: case presentation and literature review

Chronic venous disease (CVD) is a disorder of the lower limbs that affects a significant proportion of people worldwide. Signs of extensive CVD primarily include varicose veins, while in the advanced stages, irreversible dermal lesions such as dermatitis with lipodermatosclerosis and leg ulceration may occur. Phlebosclerosis refers to a fibrous degeneration affecting the vein wall, primarily the intima, with or without the presence of calcification. We present here the case of a 71-year-old patient diagnosed with advanced CVD, which presented varicose veins, hyperpigmentation with thickening of the skin and severe venous ulceration of the right leg. Two years prior, he underwent skin graft surgery for chronic venous ulcer. Ultrasonography of the great saphenous vein (GSV) revealed venous reflux at the saphenofemoral junction (SFJ) and an aneurysmal dilatation of the vein with a shiny mass located inside. Ablation of GSV was performed sequentially through the cryostripping procedure, and phlebosclerosis with calcification was identified. Postoperative recovery was rapid, and the intervention resulted in ulcer resolution within two weeks and no recurrence in the following year. A literature review of this association is also presented.