Classification of lower extremity chronic venous disorders
- Greg Moneta, MD
Greg Moneta, MD
- Professor and Chief, Vascular Surgery
- Oregon Health and Science University
- Section Editors
- John F Eidt, MD
John F Eidt, MD
- Section Editor — Vascular and Endovascular Surgery
- Professor of Surgery, Texas A&M Health Science Center
- Vice Chair of Vascular Surgical Services, Baylor Heart and Vascular Hospital at Dallas
- Joseph L Mills, Sr, MD
Joseph L Mills, Sr, MD
- Section Editor — Vascular and Endovascular Surgery
- Professor and Chief
- Division of Vascular Surgery and Endovascular Therapy
- Baylor College of Medicine
Lower extremity chronic venous disorders encompass an entire spectrum of morphologic and functional abnormalities of the venous system. They can present in childhood as congenital lesions or acquired disorders which by adulthood are quite common. Vein-related problems may or may not be symptomatic and include a wide range of clinical signs varying from minimal superficial venous dilation to edema and/or chronic skin changes with ulceration and even so-called venous claudication.
An overview of the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification of lower extremity chronic venous disorders will be presented here. An overview of the clinical evaluation and management of lower extremity chronic venous disease is presented elsewhere. (See "Overview and management of lower extremity chronic venous disease".)
Standard definitions for venous diagnosis have been adopted by international consensus .
Chronic venous disorders — This term includes the full spectrum of morphological and functional abnormalities of the venous system.
Chronic venous disease — The term chronic venous disease is used when morphological or functional abnormalities (venous valvular incompetence or venous obstruction) are present of long duration and manifested as symptoms and/or signs indicating the need for treatment and/or further investigation. Venous valvular incompetence is identified by duplex ultrasound as retrograde venous flow of abnormal duration. (See "Diagnostic evaluation of chronic venous insufficiency".)
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- Chronic venous disorders
- Chronic venous disease
- Chronic venous insufficiency
- CEAP CLASSIFICATION
- Clinical signs (The "C" component of CEAP)
- - No visible or palpable signs of venous disease (C0)
- - Telangiectasias/reticular veins (C1)
- - Varicose veins (C2)
- - Edema (C3)
- - Pigmentation or eczema (C4a)
- - Lipodermatosclerosis (C4b)
- - Healed venous ulcer (C5)
- - Active venous ulcer (C6)
- Etiology (The "E" component of CEAP)
- - Congenital (Ec)
- - Primary (Ep)
- - Secondary (Es)
- - Etiology not specified (En)
- Anatomy (The "A" component of CEAP)
- - Superficial venous system (As)
- - Perforating veins (Ap)
- - Deep venous system (Ad)
- - Anatomy not specified (An)
- Pathophysiology (The "P" component of CEAP)
- - Venous reflux (Pr)
- - Venous obstruction (Po)
- - Venous reflux and obstruction (Pr,o)
- - Reflux not specified (Pn)
- MEASURES OF CLINICAL SEVERITY
- Venous clinical severity scale
- Venous disability score
- Venous segmental disease score (VSDS)
- Villalta scale
- SUMMARY AND RECOMMENDATIONS