What is CEAP?

CEAP vein classification system was developed in order to standardize the reporting and treatment of chronic vein disorders. CEAP allows physicians to now have a uniform diagnosis of vein disorders. Use of such a classification system improves the accuracy of the diagnosis and improves communication between specialists. The elements of the CEAP classification are:

  • Clinical – what the patient’s vein looks like; severity of the problem
  • Etiology – cause of the problem and whether it is inherited or not
  • Anatomy – which veins are involved
  • Pathophysiology – is there normal or abnormal blood flow? Is there any blockage?

According to the American College of Phlebology, “The CEAP vein classification system describes what the doctor sees on the physical exam, the cause of the problem, the location in the leg, and the mechanism responsible for the manifestation of the vein problem. If you, as a patient, were able to recognize what CEAP classification you are in, it might be helpful for you to decide if and when you should seek help.”

What are the 7 Categories of the Clinical Section?

While vein disorders are common in the legs and thighs, the symptoms and appearance of these disorders can be quite unique. These 7 categories help to standardize the vein disorder, which assists specialists in determining the cause and severity of each disorder.

  1. C0 – No evidence of vein disease.
  2. C1 – Superficial spider veins only.
  3. C2 – Simple varicose veins only.
  4. C3 – Ankle edema, which is the abnormal buildup of fluid in the leg (swelling).
  5. C4 – A brown discoloration of the skin develops in the area just above the ankle.
  6. C5 – A healed venous ulcer.
  7. C6 – An open venous ulcer.

What is the difference between spider veins and varicose veins?

Spider veins are very fine veins that are visible just under the skin on the leg.  They are blue or purplish in color and usually form a tree-like pattern.  If you press on the spider veins they will lose their color as the blood they contain is squeezed out.  Varicose veins are dilated, twisted leg veins that are visible under the skin, particularly when standing.  They may have a bluish color.

While the veins are different, spider veins are actually just smaller varicose veins. The presence of spider veins can be determined with a basic examination of the skin. Varicose veins require a more extensive examination that could include ultrasounds/dopplers and blood tests.

To learn more, visit Dr. Klein’s page on varicose and spider veins treatment options.

CEAP Classification – Why is it Important to Patients?

If you have any of the findings mentioned above, depending on the severity, you may wish to be evaluated by a doctor. The CEAP classification helps us to communicate the severity of the problem to insurance companies and to other doctors, as needed. If you feel symptoms in your legs and notice higher CEAP score type changes, you may want to make an appointment to be screened for the presence of significant vein disease.

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