Venous giant post-thrombotic chronic ulcer: successful treatment with Bosentan

Abstract

To report a case of a refractory post-thrombotic chronic venous ulcer managed with an off-label treatment. We present the case of an 82-year-old woman with a previous medical history of severe hypertension and a deep vein thrombosis three years before. A refractory giant chronic venous ulcer in her left leg was treated with Bosentan. The appearance of the ulcer improved in the first 45 days, worsened after an unintended stop of the treatment and was almost resolved after 90 days of treatment. Ulcer-associated pain improved very quickly and so, in only one week, opioid treatment was stopped. Bosentan treatment was well tolerated, with only mild and manageable side effects. Treatment with Bosentan has been successful in the treatment of this case of refractory chronic venous ulcer.