In order to standardize the reporting and treatment of the diverse manifestations of chronic venous disorders, a comprehensive classification system (CEAP) was 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 an 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).
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.
According to the CEAP classification, chronic venous disorders can be divided into seven clinical classes C0 to C6 with specific signs:
C2: Varicose veins
C4: Skin changes (pigmentation, eczema, induration)
References: (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.