799 - Interventional Radiology in Complex Wound Management: A Primer on Wound Care for the Peripheral Interventionist

Monday, April 13, 2026

5:39 PM - 5:45 PM ET

Abstract Presenter(s)

NG

Nicole Galiber, MS

Medical Student
Wright State University Boonshoft School of Medicine, United States

Author/Co-author(s)

MS

Mohamed Soumakieh, BS

Medical Student
Wright State University Boonshoft School of Medicine, United States
YB

Yeman Bakdalieh, BA

Medical Student
Ohio University College of Osteopathic Medicine, United States
Mina S. Makary, MD (he/him/his)

Interventional Radiologist
The Ohio State University Wexner Medical Center, United States

Learning Objectives:

Review the role of IR in managing chronic venous ulcers and complex wounds

Illustrate the impact of endovenous ablation and iliac vein stenting on ulcer healing and recurrence

Provide pearls for integrating IR with multidisciplinary wound care

Background: Chronic wounds, particularly venous leg ulcers (VLUs), impose a considerable global health and economic burden, costing > $2.5B annually with 15–35% recurrence {1}. Compression therapy remains the cornerstone of care, but does not correct the underlying venous hypertension. Superficial venous reflux and iliac venous outflow obstruction are frequent contributors; correction accelerates healing and reduces recurrence {2,4}. IR’s play a critical role in addressing both reflux and central obstruction, complementing standard wound management practices.

Clinical Findings/Procedure Details: Evidence supports a two-tiered IR approach. For superficial venous reflux, the EVRA randomized trial demonstrated that early endovenous ablation plus compression significantly shortened healing time and prolonged ulcer-free time compared with compression alone {2}. A 2019 - 2022 retrospective study of CEAP C6 patients showed iliac stenting improved healing rates, venous clinical severity scores, and quality of life compared to non-stented patients {4}. Computed tomography venography (CTV) enhanced diagnosis by reducing procedure time and contrast dose while accurately identifying compression and collateral circulation {4}.

Procedural pearls: use of duplex ultrasound as the first-line diagnostic test with CTV or intravascular ultrasound for definitive anatomic assessment {3,4}; performing catheter-directed radiofrequency or laser ablation to the lowest point of reflux in conjunction with compression; deploying appropriately sized iliac stents (12–16 mm) with extension into the IVC to prevent migration; and integrating IR therapies with wound care practices such as debridement and compression optimization.

Conclusion and/or Teaching Points: IR plays an essential role in complex wound management by directly addressing venous reflux and central outflow obstruction. Early endovenous ablation accelerates ulcer healing when combined with compression, while iliac stenting improves outcomes in patients with iliac vein compression and active ulcers. Optimal imaging, precision, and team-based care maximize healing, and reduce recurrence.