Pathophysiology of Veins – Telangiectasia

As noted by Hexsel and Alegre, the term telangiectasia was first introduced by Von Graf to describe a superficial vessel of the skin visible to human eye. Individually, they can measure from 0.1-1.0 mm in diameter and represent an expanded venule, capillary or arteriole. Telangiectasia can originate from arterioles or venules.

Telangiectasia can be classified into four types based on clinical appearance:

Sinus or Simple (Linear): A red, linear telangiectasia that occurs on the face, especially the nose or legs. In addition, a blue linear of anastomosing telangiectasia may be found often on the legs.

Arborizing: A treelike appearance of capillary vessels in inflamed condition.

Spider or Star: A red, superficial telangiectasia arising from a central filling vessel of arteriolar origin. It is a focal network of dilated capillaries seen chiefly in pregnancy and hepatic cirrhosis. These are characteristically 0.1-1.0   mm in diameter and red to cyanotic in color.

Punctiform (Papular): Characterized by small circumscribed, superficial elevation of the skin, and are the results of dilated vessels. These are generally less than 2 mm in diameter, and frequently present in patients with collagen vascular disease.

Telangiectasia is generally progressive; however, certain patients may experience spontaneous stabilization of the disease in early stages. Treatment of early stage disease may prevent the progression and cause regression of the disease process.

Telangiectasia is one of the most common vascular lesions seen by physicians with a reported incidence of 30% in the general population.

More specifically, leg vein pathology can affect up to 80 million adults in the United States alone. Similar occurrences have been reported in Western Europe. Women tend to develop leg vein pathology 3 to 4 times as often as men do, with reported estimates ranging from 29-41% to 6-15% respectively.

The Cynergy laser system effectively targets veins that are between 0.3 mm and 3.0 mm in size. This system delivers the combination of wavelength, high fluence and long pulses required to effectively treat large veins. Precise custom treatment of the vessel can be achieved while similar surrounding structures, such as the epidermis, remain largely unharmed.