Vein specialists & information on phlebology

What is phlebology?

Phlebology deals with diseases of the veins. It includes the diagnosis and treatment of pathological changes in the venous system, particularly in the legs, such as varicose veins (varicose veins), spider veins and thrombosis.

Which specialists are phlebologists?

Vein specialists, i.e. phlebologists, are usually specialists in

• Dermatology (dermatologists),
• general medicine,
• internal medicine or
• surgery,

who have completed 1.5 years of further training. This allows them to carry the additional designation of phlebology.

As the symptoms of venous disorders often occur on the skin, many patients turn to their dermatologist or general practitioner first. Phlebology clinics are often also skin clinics.

Which diseases are treated by phlebologists / vein specialists?

The spectrum of vein diseases is broad. Vein specialists treat the following vein conditions, among others:

• Spider veins are small, reticular or fan-shaped veins located directly in the epidermis, which are generally not a medical condition but are still a cosmetic problem for many people.
• In varicose veins, the venous valves in the leg veins no longer function properly, meaning that the blood is not transported back to the heart sufficiently. The build-up of blood in the legs leads to the characteristic dilation of the vessels.
• Thrombosis is the blockage of veins by a blood clot.
• Ulcus cruris is colloquially known as an open leg. This is typically an open and weeping wound on the lower leg that does not heal over a long period of time.
• In the case of phlebitis(inflammation of the veins), the inflammation of the superficial veins can be recognized by painful, red and heated strands. As there is a risk of thrombosis, the patient should consult a phlebology specialist immediately.
• In chronic venous insufficiency, there is insufficient transportation of blood to the heart. This leads to changes in the veins and skin and, in advanced stages, to leg ulcers.

Spider veinsappear as net-like lines on the skin @ Rung Kh /AdobeStock

What diagnostic procedures do vein specialists use?

Before treating venous diseases, phlebologists will carry out a detailed physical examination. Some vein conditions, such as spider veins, can be seen with the naked eye alone.

However, phlebologists may also have to resort to instrument-based procedures. Typical procedures used by vein specialists to diagnose venous disorders are phlebography and Doppler/duplex sonography.

Phlebography is an X-ray examination of the veins. With the help of a contrast medium, which makes the blood in the vessels stand out better from the surrounding area on the X-ray image, the vascular system can be visualized very well and a lack of or insufficient blood flow, thrombosis or dilatation can be detected. Magnetic resonance imaging can also be used instead of an X-ray examination.

Doppler/duplex sonography, on the other hand, is a special form of ultrasound examination that can be used to determine the blood flow velocity and detect changes in flow conditions. This in turn allows conclusions to be drawn about insufficient blood flow or obstacles such as thromboses that obstruct the blood flow.

What treatments/therapies are used in phlebology?

Depending on the disease, vein specialists have various options available for the treatment of venous diseases, for example

• Vein sclerotherapy / sclerotherapy involves injecting a medication into the pathologically altered vein (for example in varicose veins), which causes the vessel to collapse.
• Vein stripping is the treatment of choice for varicose veins in truncal veins. After inserting a probe into the veins and then cutting through the abnormally dilated areas, the varicose veins are also removed (stripping).
• In radiofrequency ablation for varicose veins, a catheter probe is inserted into the diseased vein. A high-frequency current then generates heat, which closes the vessel.
• In laser treatment, the varicose vein is closed by a laser-generated artificial thrombosis.
• Compression therapy is often used as one of the first measures in the treatment of venous diseases, but is also used alongside other procedures. This involves applying pressure to the veins from the outside with the help of bandages and stockings (so-called support stockings). This constricts the vessels and increases the blood flow rate. In addition, wounds heal faster, oedema is reduced and thrombosis is prevented.

Compression stockings exert pressure on the veins, relieving them @ tibanna79 /AdobeStock

How do I find the "best clinic" for phlebology?

It is not possible to designate a clinic as the "best clinic" or "top clinic" for phlebology. However, there are doctors and clinics that specialize in the treatment of venous diseases and have extensive experience. You can find these phlebology experts in the Leading Medicine Guide.

What makes our doctors specialists in phlebology?

Only selected highly qualified medical experts and specialists are presented in the Leading Medicine Guide. All listed doctors have a high level of specialist expertise, have excellent experience in the field of phlebology and meet the strict inclusion criteria of the Leading Medicine Guide.