Venous Insufficiency Guidelines

Updated: Sep 25, 2020
  • Author: Robert Weiss, MD; Chief Editor: William D James, MD  more...
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Guidelines Summary

The Clinical, Etiology, Anatomic, Pathophysiology (CEAP) classification was developed by an international consensus conference to provide uniformity in the reporting, diagnosing, and treating  CVI. [21]

Clinical classification is as follows:

  • C0 - No visible signs of venous disease
  • C1 - Telangiectases or reticular veins
  • C2 - Varicose veins
  • C3 - Edema without skin changes
  • C4 - Changes in skin and subcutaneous tissue: A = Pigmentation or eczema; B = Lipodermatosclerosis or atrophie blanche
  • C5 - Healed ulcer
  • C6 - Active ulcer

Etiologic classification is as follows:

  • Congenital (ie, Klippel-Trenaunay syndrome)
  • Primary
  • Secondary (ie, postthrombotic syndrome, trauma)
  • No venous cause identified

Anatomic classification is as follows:

  • Superficial
  • Deep
  • Perforator
  • No venous location identified

Pathophysiologic classification is as follows:

  • Reflux
  • Obstruction, thrombosis
  • Reflux and obstruction
  • No venous pathophysiology identified in advanced stages