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The CEAP classification consensus document was written by the American Venous Forum in 1994, updated in 1996 and revised in 2004 to provide a comprehensive objective classification.  It was universally accepted and endorsed, with most published papers now using all or portions of the CEAP system. It was comprised of two parts: classification and severity scoring.


C – clinical manifestation

E – etiologic factors

A – anatomic distribution

P – pathophysiologic dysfunction

Severity Scoring

  • Number of anatomic segments affected
  • Grading of signs and symptoms
  • Disability
  • Revision

As a result of now meaningful scientific communication of venous disease, improvements in diagnosis and treatment followed.  This naturally led to the need to update and refine CEAP.  Based on international consensus recommendations, the AVF published a revised CEAP document in 2020.  These changes include adding Corona phlebectatica as the C4c clinical subclass, introducing the modifier “r” for recurrent varicose veins and recurrent venous ulcers, and replacing numeric descriptions of the venous segments by their common abbreviations.

CEAP Tables
CEAP Notation
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