In order to standardize the reporting and treatment of the diverse manifestations of chronic venous disorders, a comprehensive classification system (CEAP) has been developed to allow uniform diagnosis and comparison of patient populations. Created by an international ad hoc committee of the American Venous Forum in 1994, it has been endorsed throughout the world and is now accepted standard for classifying chronic venous disorders.
The fundamentals of the CEAP classification include a description of the clinical class (C) based upon objective signs, the etiology (E), the anatomical (A) distribution of reflux and obstruction in the superficial, deep and perforating veins, and the underlying pathophysiology (P), whether due to reflux or obstruction. (1)
Seven clinical categories are recognized as shown on the table below:
CEAP classification of chronic venous disease
Clinical classification
C0: no visible or palpable signs of venous disease
C1: telangiectasies or reticular veins
C2: varicose veins
C3: edema
C4a: pigmentation or eczema
C4b: lipodermatosclerosis or athrophîe blanche
C5: healed venous ulcer
C6: active venous ulcer
S: symptomatic, including ache, pain, tightness, skin irritation, heaviness, and muscle cramps, and other complaints attributable to venous dysfunction
A: asymptomatic
Etiology classification
Ec: congenital
Ep: primary
Es: secondary
En: no venous cause identified
Anatomic classification
As: superficial veins
Ap: perforating veins
Ad: deep veins
An: no venous location identified
Pathophysiologic
Pr: reflux
Po: obstruction
Pr,o: reflux and obstruction
Pn: no venous pathophysiology identifiable
Designed to be a document that would evolve over time CEAP underwent its first official review and revision by an international panel under the auspices of the American Venous Forum in 2004 (2). The revised document retains the basic CEAP categories, but improves the underlying details. Furthermore, to encourage wider usage among clinicians, an abbreviated or "basic CEAP" was adopted as an alternative to the comprehensive CEAP. (3)
To help doctors get familiar and use the CEAP classification, Prof. Jean-François Uhl and SIGVARIS are providing an educational CD: "The CEAP game". 
Available in English and French, please us the contact form to receive a complimentary sample of the CD.
(1) Porter JM, Moneta GL. Reporting standards in venous disease: an update. International Consensu Committee on Chronic Venous Disease. J Vasc Surg 1995;21:635-45
(2) Eklof B, Rutherford RB, Bergan JJ, Carpentier PH, Glovicski P, Kistner RL, et al. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Sur 2004;40:1248-52
(3) Meissner et al. Primary chronic venous disorders. J Vasc Surg 2007;46:54S-67S