The Future of Phlebology in Europe.
BACKGROUND
Worldwide superficial and deep venous diseases are common and associated with significant individual and socioeconomic morbidity. Increasing burden of venous disease requires Phlebology to define itself as an independent specialty representing not only patients but the multidisciplinary physicians involved in venous care.


RESULTS
In this article the scope of venous disease in Europe and subsequent future governance for treatment in the region is discussed. Superficial venous disease is common with 26.9-68.6% of European populations reported to have C2-C6 disease according to the CEAP (Clinical severity, Aetiology, Anatomy and Pathophysiology) scoring system. However, a significant disparity is observed in the treatment of superficial venous disease across Europe. Post thrombotic syndrome (PTS) after deep vein thrombosis (DVT) contributes to the increasing burden of deep venous disease. Aggressive thrombus removal for acute ileofemoral DVT provides a cost-effective 14.4% risk reduction in the development of PTS. Additionally, deep venous lesions requiring endovascular intervention are being increasingly performed to prevent recurrent thrombosis. The European College of Phlebology (ECoP) has been formed to provide a responsible body for the care of the European patient with venous disease. The role of the ECoP includes unifying European member states through standardised guideline production, identification of research strategy and provision of training and accreditation of physicians.


CONCLUSIONS
Creation of a European venous disease specific speciality will provide a patient centred approach through understanding of the impact of disease in the region and delivery of high quality diagnostics and treatment from an appropriately certified Phlebologist.
Academic Section of Vascular Surgery, Imperial College London, London, UK b.dharmarajah@imperial.ac.uk.
Brahman
B
Dharmarajah
Academic Section of Vascular Surgery, Imperial College London, London, UK.
Tristan Ra
TR
Lane
Academic Section of Vascular Surgery, Imperial College London, London, UK.
Hayley M
HM
Moore
Department of Dermatology, Erasmus MC - Rotterdam, The Netherlands.
Ha Martino
HM
Neumann
Department of Dermatology, University of Bonn, Germany.
Eberhard
E
Rabe
European Venous Centre Aachen-Maastricht, Maastricht University, The Netherlands Uniklinik Aachen, Germany.
Cees Ha
CH
Wittens
Academic Section of Vascular Surgery, Imperial College London, London, UK.
Alun H
AH
Davies
Varicose veins; chronic venous disease; education; healthcare burden; post-thrombotic syndrome