CEAP classification for chronic venous disorders

Chronic Venous Disorders (CVD) is a collective term that describes a long-standing condition involving impaired venous return in varying degrees of severity. To distinguish the different manifestations of CVD, the CEAP classification system is used.

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What is CEAP classification?

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.

CEAP: Seven clinical classes of chronic venous disorders

According to the CEAP classification, chronic venous disorders can be divided into seven clinical classes C0 to C6 with specific signs:

C0: No visible or palpable signs of venous disease

C1: Telangiectasis (spider veins) or reticular veins

C2: Varicose veins

C3: Edema

C4: Skin changes (pigmentation, eczema, induration)

C5: Healed venous ulcer

C6: Active venous ulcer

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.

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