CEAP Classification for Varicose Veins
The internationally recognized CEAP (Clinical-Etiology-Anatomy-Pathophysiology) classification system serves as a standard for describing chronic venous disorders in patients and reporting research findings in scientific journals. Due to ongoing developments in the understanding of venous disorders, including chronic venous diseases (CVD, C2-C6), periodic analysis and revisions of the CEAP classification have become necessary. Guided by principles like reproducibility, compatibility with previous versions, evidence-based approach, and practicality in clinical use, the Task Force employed the revised Delphi process to propose several changes. These revisions include the addition of Corona phlebectatica as a C4c clinical subclass, introducing the “r” modifier for recurrent varicose veins and venous ulcers, and using common abbreviations instead of numeric descriptions for venous segments.
(Terminology specific to varicose veins, Venous Clinical Severity Score (VCSS) and other publications can be seen by clicking on link.)
| CEAP_Category | Description |
|---|---|
| C0 | No visible or palpable signs of venous disease |
| C1 | Telangiectasias or reticular veins |
| C2 | Varicose veins |
| C2r | Recurrent Varicose Veins |
| C3 | Edema |
| C4 | Changes in Skin and subcutaneous tissue secondary to chronic venous disease |
| C4a | Pigmentation or eczema |
| C4b | Lipodermatosclerosis or atrophie blanche |
| C4c | Corona phlebectatica |
| C5 | Healed venous ulcer |
| C6 | Active venous ulcer |
| C6r | Recurrent Active venous ulcer |
| Etiological Classification | |
| Ec | Congenital |
| Ep | Primary |
| Es | Secondary |
| Esi | Secondary - Intravenous Cause |
| Ese | Secondary - Extravenous Cause |
| En | None Identified |
| Anatomic Classification (Instead on Number, abbreviation are used) | |
| As | Superficial System (Tel, Ret, GSVa, GSVb, SSV, AASV, NSV) |
| Ad | Deep System (IVC, CIV, IIV, EIV, PELV, CFV, DFV, FV, POPV, TIBV, PRV, ATV, PTV, MUSV, GAV, SOV) |
| Ap | Perforator (TPV, CPV) |
| An | No venous location identified |
| Pathological Classification | |
| Pr | Reflux |
| Po | Obstruction,Post-thrombotic syndrome |
| Pr,o | Reflux, Obstruction |
| Pn | No pathophysiology identified |
Tel – Telangiectasia, Ret – Reticular veins , GSVa – Great saphenous vein above knee, GSVb – Great saphenous vein above knee, SSV – Small saphenous vein, AASV – Anterior Accessory Saphenous Vein, NSV – Non Saphenous Vein, IVC – Inferior Vena Cava, CIV – Common Iliac vein, IIV – Internal Iliac Vein, EIV – External Iliac vein, PELV – Pelvic Veins, CFV – Common Femoral Vein, DFV – Deep Femoral Vein, FV – Femoral Vein, POPV – Popliteal Vein, TIBV – Tibial (Crural) Vein, PRV – Peroneal Vein, ATV – Anterior Tibial Vein, PTV – Posterior Tibial Vein, MUSV – Muscular Veins, GAV – Gastrocnemius Veins, SOV – Soleal Vein, TPV – Thigh Perforator Vein, CPV – Calf Perforator Vein
2. Sclerotherapy: Treatment of Varicose and Telangiectatic Leg Veins 6th edition