Classification system

Classification system

The descriptive CEAP (Clinical–aEtiology–Anatomy–Patho physiology) classification for chronic venous disorders is widely utilised. - -

Figure 62.6 Advanced skin changes: lipodermatosclerosis, eczema and atrophie blanche. Figure 62.7 Pigmentation (haemosiderosis) and mild eczema. Figure 62.8 Severe eczema. Figure 62.9 Haemosiderosis and mild lipodermatosclerosis of the calf skin.

For clinical classification: /uni25CF C0: no signs of venous disease; /uni25CF C1: telangiectasia or reticular veins; /uni25CF C2: varicose veins; /uni25CF C3: oedema; /uni25CF C4a: pigmentation or eczema; /uni25CF C4b: LDS or atrophie blanche; /uni25CF C4c Corona phlebectatica /uni25CF C5: healed venous ulcer; /uni25CF C6: active venous ulcer. Clinical class can be further characterised as symptomatic (s), asymptomatic (a) or recurrent following previous successful treatment or healing (r), e.g. C2a, C2s, C6r. For aetiological classification: /uni25CF Ec: congenital; /uni25CF Ep: primary; /uni25CF Es: secondary (post-thrombotic); /uni25CF En: no venous cause identified. For anatomical classification: /uni25CF As: superficial veins; /uni25CF Ap: perforator veins; /uni25CF Ad: deep veins; /uni25CF An: no venous location identified. For pathophysiological classification: /uni25CF Pr: reflux; /uni25CF Po: obstruction; /uni25CF Pr,o: reflux and obstruction; /uni25CF Pn: no venous pathophysiology identifiable. In clinical practice, patients are normally categorised as having ‘varicose veins’ or ‘venous ulcers’. Cases of varicose veins may be uncomplicated or complicated. Complications may be chronic (as discussed above) or acute, including superficial vein thrombosis (thrombophlebitis) and bleeding. Uncomplicated varicose veins may be asymptomatic or symptomatic.

Figure 62.10 Venous ulcer.