A phlebologist is a doctor who assesses diseases of the veins. At Centro Medico Gargano in Naples, the consultation aims to establish the cause of varicose veins, spider veins, swelling, heaviness, pain and other venous circulation concerns, rather than recommending the same treatment to everyone.
Assessment is carried out by Dr Ciro Gargano, a medical doctor and specialist in Diagnostic Radiology practising angiology and phlebology. The service available to book online is ‘Colour Doppler Ultrasound and Vascular Consultation’, which includes a medical history, specialist consultation, colour Doppler examination of the relevant vascular area and a medical report.
When to consult a phlebologist
A phlebological assessment may be useful for:
- varicose veins or dilated, tortuous superficial veins;
- spider veins and telangiectasias, especially before planning treatment;
- swelling, heaviness, tightness, itching or cramps in the legs;
- skin changes, pigmentation, eczema or leg ulcers;
- hard, painful veins or previous episodes of thrombosis and thrombophlebitis;
- follow-up after previous venous treatments.
Sudden swelling of one leg, significant pain, extensive redness, breathing difficulties or chest pain require prompt medical assessment rather than a routine appointment that can be deferred.
What happens during a phlebology consultation
The consultation begins with your medical history: symptoms, duration, family history, pregnancies, work, physical activity, medicines, previous procedures and any thrombotic episodes. The leg examination considers the distribution of varicose veins, oedema, skin, spider veins and signs of venous insufficiency or other conditions.
Not every leg symptom is caused by the veins. Swelling and pain can have different causes, so diagnosis comes before choosing treatment. Further information is available on swollen and heavy legs.
The role of venous colour Doppler ultrasound
Colour Doppler ultrasound examines deep-vein patency, the superficial system, saphenous veins, major junctions, reflux and varicose tributaries. It may be performed lying down and standing, with dynamic manoeuvres, when required by the clinical question.
The examination helps distinguish a primarily aesthetic concern from functional venous disease and establish whether monitoring, compression, sclerotherapy, saphenous vein treatment or other options are appropriate.
Which problems are assessed
Varicose veins and venous insufficiency
The presence of varicose veins may be associated with reflux, pain, heaviness, swelling, itching and skin changes. Treatment depends on the location of the problem, rather than just the external appearance of the veins.
Spider veins and telangiectasias
Spider veins may be isolated or fed by reticular veins and associated with a wider venous problem. Spider vein sclerotherapy and other techniques are considered after establishing the characteristics and origin of the visible vessels.
Ulcers and skin changes
A leg wound is not automatically venous. The page about venous ulcers explains why arterial circulation and other possible causes should also be considered.
Possible treatments and care pathways
After diagnosis, recommendations may include regular monitoring, physical activity, addressing contributing factors, compression therapy, liquid or foam sclerotherapy, treatment of varicose tributaries, procedures for saphenous insufficiency or referral to another specialist. Indications, benefits, limitations and possible adverse effects are discussed in relation to the individual condition.
Dr Ciro Gargano
Dr Ciro Gargano graduated in Medicine and Surgery from the University of Naples Federico II, holds a specialist qualification in Diagnostic Radiology and a second-level university Master’s degree in Haemodynamics and Advanced Venous Surgery from the University of Ferrara. His practice combines clinical assessment, vascular ultrasound diagnostics and treatment of venous conditions. The full profile is available on Angiology and phlebology in Naples: Dr Ciro Gargano.
Frequently asked questions
What is the difference between angiology and phlebology?
Angiology covers arteries, veins and microcirculation more broadly. Phlebology focuses on venous conditions. In practice, these areas of expertise may complement each other.
What does the service available to book online include?
The service ‘Colour Doppler Ultrasound and Vascular Consultation’ includes a medical history, specialist consultation, colour Doppler ultrasound of the relevant vascular area and a medical report. Clinical and diagnostic assessments are therefore combined in one appointment.
Can I have an assessment just for spider veins?
Yes. Assessment establishes whether the spider veins are isolated and which technique may be most appropriate, without promising complete or permanent removal.
Is treatment decided during the consultation?
An initial direction can often be established at the first assessment. More complex cases may require further tests or separate planning.
Reference sources
The general approach is consistent with the NICE guideline on the diagnosis and management of varicose veins and the ESVS guidelines on chronic venous disease of the lower limbs.
For the address and practical directions, see Contact and directions.
