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Phlebology is a medical speciality that is concerned with
venous Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenated b ...
issues including the diagnosis and treatment of disorders of the
vein Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenated b ...
s. A medical specialist in this field is known as a phlebologist. The specialty of phlebology has developed to enable physicians sharing an interest in venous disease and health to share knowledge and experience despite being trained in a variety of backgrounds such as
dermatology Dermatology is the branch of medicine dealing with the skin.''Random House Webster's Unabridged Dictionary.'' Random House, Inc. 2001. Page 537. . It is a speciality with both medical and surgical aspects. A dermatologist is a specialist medical ...
,
vascular surgery Vascular surgery is a surgical subspecialty in which diseases of the vascular system, or arteries, veins and lymphatic circulation, are managed by medical therapy, minimally-invasive catheter procedures and surgical reconstruction. The specialty ...
,
haematology Hematology ( always spelled haematology in British English) is the branch of medicine concerned with the study of the cause, prognosis, treatment, and prevention of diseases related to blood. It involves treating diseases that affect the produc ...
, interventional radiology or general medicine. Diagnostic techniques used include the patient's history and physical examination, venous imaging techniques in particular vascular ultrasound and laboratory evaluation related to
venous thromboembolism Venous thrombosis is blockage of a vein caused by a thrombus (blood clot). A common form of venous thrombosis is deep vein thrombosis (DVT), when a blood clot forms in the deep veins. If a thrombus breaks off (embolizes) and flows to the lungs to ...
. The
American Medical Association The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was approximately 240,000 in 2016. The AMA's state ...
and the
American Osteopathic Association The American Osteopathic Association (AOA) is the representative member organization for the more than 176,000 osteopathic medical doctors (D.O.s) and osteopathic medical students in the United States. The AOA is headquartered in Chicago, Illinoi ...
have added phlebology to their list of self-designated practice specialties.


Scope of practice

A significant part of a phlebologist's work is involved with the treatment of superficial venous disease, frequently of the leg. Conditions often treated include venous stasis ulcers,
varicose veins Varicose veins, also known as varicoses, are a medical condition in which superficial veins become enlarged and twisted. These veins typically develop in the legs, just under the skin. Varicose veins usually cause few symptoms. However, some indi ...
and spider veins (
telangiectasia Telangiectasias, also known as spider veins, are small dilated blood vessels that can occur near the surface of the skin or mucous membranes, measuring between 0.5 and 1 millimeter in diameter. These dilated blood vessels can develop anywhere on ...
). Other conditions managed by phlebologists include deep venous thrombosis (
DVT Deep vein thrombosis (DVT) is a type of venous thrombosis involving the formation of a blood clot in a deep vein, most commonly in the legs or pelvis. A minority of DVTs occur in the arms. Symptoms can include pain, swelling, redness, and enla ...
), superficial
thrombophlebitis Thrombophlebitis is a phlebitis (inflammation of a vein) related to a thrombus (blood clot). When it occurs repeatedly in different locations, it is known as thrombophlebitis migrans (migratory thrombophlebitis). Signs and symptoms The following s ...
, and venous
malformations A birth defect, also known as a congenital disorder, is an abnormal condition that is present at childbirth, birth regardless of its cause. Birth defects may result in disability, disabilities that may be physical disability, physical, intellect ...
.


Societies and Associations

The Union Internationale de Phlébologie (UIP) is committed to the global expansion of knowledge in the growing field of phlebology and aims to facilitate the advancement of science by encouraging research and education in all aspects of venous and lymphatic disease. The Union is ultimately aiming to facilitate comprehensive training programs in its member countries with the ultimate aim of establishing phlebology as a recognised  multidisciplinary specialty of medicine.   The Australasian College of Phlebology (ACP) founded in 1993 has established a comprehensive four year training program in phlebology incorporating an online modular curriculum that complements supervised clinical training. The
American Medical Association The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was approximately 240,000 in 2016. The AMA's state ...
added phlebology to their list of self-designated practice specialties in 2005. In 2007 the American Board of Phlebology (ABPh), subsequently known as the American Board of Venous & Lymphatic Medicine (ABVLM), was established to improve the standards of phlebologists and the quality of their patient care by establishing a certification examination, as well as requiring maintenance of certification. Although not a Member Board of the American Board of Medical Specialties (ABMS), the American Board of Venous & Lymphatic Medicine uses a certification exam based on ABMS standards. The
American Vein and Lymphatic Society American(s) may refer to: * American, something of, from, or related to the United States of America, commonly known as the "United States" or "America" ** Americans, citizens and nationals of the United States of America ** American ancestry, pe ...
(AVLS), formerly the American College of Phlebology (ACP) one of the largest medical societies in the world for physicians and allied health professionals working in the field of phlebology, has 2000 members. The AVLS encourages education and training to improve the standards of medical practitioners and the quality of patient care. The
American Venous Forum (AVF) The American Venous Forum (AVF) is the major national academic society focused on venous and lymphatic disease in the United States. Its mission includes education, research, and advocacy. The AVF is the sponsor organization for the ''Journal of ...
is a medical society for physicians and allied health professionals dedicated to improving the care of patients with venous and lymphatic disease. The majority of its members manage the entire spectrum of venous and lymphatic diseases – from varicose veins to congenital abnormalities to deep vein thrombosis to chronic venous diseases. Founded in 1987, the AVF encourages research, clinical innovation, hands-on education, data collection and patient outreach.


Certification

Regulatory requirements for phlebology certification are different in Europe and the US. In the US, licensed physicians with documented experience in treating veins and adequate vascular ultrasound experience can receive certification by passing a test created by the American Board of Venous and Lymphatic Medicine a privately owned corporation committed to maintaining a high standard of care for venous disease. The test addresses knowledge of venous disease, clotting disorders, imaging modalities, pharmacokinetics, vascular malformations, lymphatics disorders and venous embryology. The American Board of Venous and Lymphatic Medicine results in certification as a "Diplomate of the American Board of Venous and Lymphatic Medicine" which is based on standards set by the American Board of Medical Specialities. Providers with this designation have completed rigorous criteria to sit for the exam and comprehension of vein care principles to pass the exam according to the Board. In
Australasia Australasia is a region that comprises Australia, New Zealand and some neighbouring islands in the Pacific Ocean. The term is used in a number of different contexts, including geopolitically, physiogeographically, philologically, and ecologica ...
, the Australian College of Phlebologists requires that applicants be residents in
Australia Australia, officially the Commonwealth of Australia, is a Sovereign state, sovereign country comprising the mainland of the Australia (continent), Australian continent, the island of Tasmania, and numerous List of islands of Australia, sma ...
or
New Zealand New Zealand ( mi, Aotearoa ) is an island country in the southwestern Pacific Ocean. It consists of two main landmasses—the North Island () and the South Island ()—and over 700 smaller islands. It is the sixth-largest island count ...
; have current registration as a medical practitioner in Australia or New Zealand; have a recognised post-graduate qualification (e.g., FRACGP) or more than 3 years post-graduate experience in clinical medicine; have a Medicare provider number to apply for advanced training; and are a person who has satisfied the prerequisites is eligible to apply for admission to the College Training Program. There is Basic Training (minimum of 10 days' supervised training, the Written Exam and the Clinical Exam), completion of which leads to the award of the title "Certified Sclerotherapist"; Advanced Training (20 days' supervised training, the Written Exam and the Clinical Exam); and Fellowship Training, completion of which leads to Fellowship of the Australasian College of Phlebology and entitlement to use the title "Phlebologist".


References


External links


International Union of PhlebologyAmerican Vein & Lymphatic Society (formerly the American College of Phlebology)Australasian College of Phlebology''Phlebology'' journal
{{Vascular diseases Health care occupations