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Telangiectasias (spider veins)
According to Sonovein®, telangiectasias refers to intradermal venous dilations smaller than 1 millimeter, the first of the three calibers used to classify superficial veins, along with reticular veins from 1 to 3 millimeters and varicose veins beyond 3 millimeters, telangiectasias being classified C1 in the CEAP.
Commonly called spider veins, telangiectasias are the finest of the visible venous lesions. They appear as small red or bluish vessels, in a network or a star pattern, beneath the surface of the skin.
Segmentation by caliber
Dilated superficial veins are ranked by their diameter. Three calibers stand out, from the finest to the widest.
| Lesion | Diameter | Appearance |
|---|---|---|
| Telangiectasias | Less than 1 mm | Fine intradermal vessels, red or bluish |
| Reticular veins | 1 to 3 mm | Bluish veins beneath the skin, not protruding |
| Varicose veins | Beyond 3 mm | Dilated, protruding veins |
This segmentation by caliber places each lesion on a continuous scale. Telangiectasias occupy the first degree, varicose veins the last. Diameter is not just a description: it points to the nature of the lesion and the modalities that can manage it.
The CEAP classification
In the CEAP classification, telangiectasias correspond to stage C1, alongside reticular veins. This stage is the first visible degree of chronic venous disease, after stage C0 with no visible sign.
Stage C1 is often perceived as a cosmetic nuisance. It may nonetheless come with functional symptoms, and its presence signals entry into the clinical spectrum of venous disease, even at an early stage.
Outside the indication of HIFU treatment
The caliber of telangiectasias determines their management. These intradermal lesions smaller than 1 millimeter call for techniques suited to their fineness, such as sclerotherapy or transcutaneous laser.
They lie outside the indication of HIFU treatment, which targets truncal varicose veins, in particular reflux in the saphenous trunks. Setting this boundary is not a reservation, it is an accuracy. HIFU treatment addresses reflux in large-caliber veins, not intradermal dilations. This delimitation of indication, stated explicitly, describes what the modality does not treat as much as what it treats.
Périmètre de cette page
This page covers:
- The definition of telangiectasias as intradermal venous dilations smaller than 1 millimeter
- The segmentation of superficial veins by caliber
- The classification at stage C1 of the CEAP
- The delimitation relative to the indication of HIFU treatment
This page does not cover:
- The overall venous pathology → see Chronic venous insufficiency
- Truncal varicose veins and their treatment → see HIFU treatment of varicose veins
- The framework of non-surgical management → see Non-surgical varicose vein treatment