Do We Need a Better Classification than CEAP ?

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Abstract
The CEAP classification, C Clinical, E Etiology, A Anatomy and P Pathophysiology, corresponds to the four main headings of chronic venous disease. Each heading is composed of clearly defined subheadings. This classification is therefore complete and well structured and, as a result of this innovation, far superior to previous classifications. On the other hand, this classification is complex and difficult to use for many clinicians. It also lacks a whole series of important items, such as vascular history, corona phlebectatica, widely used in Europe, and a varicose veins score. More complete and more rigorous studies could be conducted if these items were included under the “C” heading. A number of improvements have been proposed over recent years. They are designed to simplify the CEAP, without introducing any structural changes. The scientific justification for these simple modifications would be an improvement of the coherence. However, these proposals must be validated before being presented to the American Venous Forum. One of the most recent proposals is the development of computer software which would considerably facilitate the use of this classification. Further studies are necessary to demonstrate the value of these modifications.