New blood pursuing phlebology training: ranks of American College of Phlebology growing at 17% per year.(Practice Trends)

A growing number of physicians are pumped up about phlebology.

"There have been some revolutionary things happening" in treatments for varicose veins and other venous problems in recent years, said Dr. Steven E. Zimmet, president-elect of the American College of Phlebology.

"Phlebology deals with modern ways of evaluating and treating different varicose vein diseases by methods other than the ancient ligation and stripping," explained Dr. Khalil Fattahi, an internist who now runs a vein specialty clinic in Los Gatos, Calif. With experience in treating tens of thousands of cases of varicose veins, Dr. Fattahi trains vascular surgeons and others in modern transcatheter varicose vein treatments, he said. Newer techniques include ultrasound-guided sclerotherapy and catheter-based endovenous laser therapy for varicose veins.

Compared with vein stripping--which entails general anesthesia, pain, 2-6 weeks of recovery, and leg scarring--the newer treatments are less invasive, can be done in an office under local anesthesia, allow patients to return to work the next day, and don't leave scars, said Dr. Michael Krusch, another internist-turned-phlebologist.

As a general internist, "on average, I probably saw six or eight people a month who had varicose veins," but his medical training had led him to believe that this was just a cosmetic complaint and that all he could offer patients were compression stockings or vein stripping. His outlook changed when he took a course on sclerotherapy for spider veins.

After seeing pictures of horrendous varicose veins, significant stasis dermatitis, venous stasis ulcers, and what could be done for these problems, "I was blown away," he said. Dr. Krusch began attending American College of Phlebology programs and ultimately took a year off of practice in 2001 to train with different U.S. phlebologists for periods from 1-2 weeks up to 2-3 months.

Today, his vein specialty clinic in Greensboro, N.C., is so busy that he'll soon open a second clinic in Winston-Salem, N.C. His most important tool is ultrasound, and he employs a vascular technologist to do the ultrasound exams.