Clinical-Etiology-Anatomy-Pathophysiology (CEAP) Classification of Venous Disease
Clinical-Etiology-Anatomy-Pathophysiology (CEAP) Classification of Venous Disease
It is considered best practice to use the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification system that represents an international consensus method to categorize chronic venous disease (Table 4). This classification system although not correlated with outcomes, does provide the clinician with a structured framework with the C or Clinical being the most useful when in clinical practice. The most recent update was published in 2020 (Musil, 2021). The major change is C4, corona phlebectatica that is considered an early marker for the development of more advanced disease. There is now a designation for a recurrent ulcer listed below as C6r.
Table 4. The CEAP Classification for Venous Disease
| CEAP tool | Meaning |
|---|---|
| C | Clinical findings |
| E | Etiological factors |
| A | Anatomical site |
| P | Pathophysiological cause |
| Clinical | C0 | No visible or palpable signs of venous disease |
|---|---|---|
| C1 | Telangiectasias or reticular veins | |
| C2 | Varicose veins | |
| C3 | Presence of oedema | |
| C4a | Eczema or pigmentation | |
| C4b | Lipodermatosclerosis or atrophie (atrophy) blanche | |
| C4c | Corona phlebectatica | |
| C5 | Evidence of a healed venous leg ulcer | |
| C6 | Active venous leg ulcer symptoms | |
| C6r | Recurrent ulcer | |
| Etiological | Ec | Congenital |
| Ep | Primary | |
| Es | Secondary (post-thrombosis) | |
| En | No venous etiology | |
| Anatomical | As | Superficial veins |
| Ap | Perforating veins | |
| Ad | Deep veins | |
| An | No venous location identified | |
| Patho- Physiologocal |
Pr | Reflux |
| Ap | Obstruction | |
| Ad | Reflux and obstruction | |
| An | No venous pathophysiology identified |
