The 2020 update of the CEAP classification system and reporting standards

Fedor Lurie, Marc Passman, Mark Meisner, Michael Dalsing, Elna Masuda, Harold Welch, Ruth L. Bush, John Blebea, Patrick H. Carpentier, Marianne De Maeseneer, Anthony Gasparis, Nicos Labropoulos, William A. Marston, Joseph Rafetto, Fabricio Santiago, Cynthia Shortell, Jean Francois Uhl, Tomasz Urbanek, André van Rij, Bo EklofPeter Gloviczki, Robert Kistner, Peter Lawrence, Gregory Moneta, Frank Padberg, Michel Perrin, Thomas Wakefield

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306 Scopus citations


The CEAP (Clinical-Etiology-Anatomy-Pathophysiology) classification is an internationally accepted standard for describing patients with chronic venous disorders and it has been used for reporting clinical research findings in scientific journals. Developed in 1993, updated in 1996, and revised in 2004, CEAP is a classification system based on clinical manifestations of chronic venous disorders, on current understanding of the etiology, the involved anatomy, and the underlying venous pathology. As the evidence related to these aspects of venous disorders, and specifically of chronic venous diseases (CVD, C2-C6) continue to develop, the CEAP classification needs periodic analysis and revisions. In May of 2017, the American Venous Forum created a CEAP Task Force and charged it to critically analyze the current classification system and recommend revisions, where needed. Guided by four basic principles (preservation of the reproducibility of CEAP, compatibility with prior versions, evidence-based, and practical for clinical use), the Task Force has adopted the revised Delphi process and made several changes. 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. This report describes all these revisions and the rationale for making these changes.

Original languageEnglish
Pages (from-to)342-352
Number of pages11
JournalJournal of Vascular Surgery: Venous and Lymphatic Disorders
Issue number3
StatePublished - May 2020


  • Chronic venous disease
  • Disease classification
  • Post-thrombotic syndrome
  • Varicose veins
  • Veins


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