Review paper
An apparent CEAP inconsistency: should the classification be revised?

CEAP is a score designed to give a synthetic description of chronic venous insufficiency (CVI). There is a conflict between the original 1996 CEAP classification and the 2004 revision. The former used a detailed anatomical representation in the anatomical A category, while the latter shifted the same codes to the pathological P category, yielding unexpected advantages. Two similar clinical cases are presented: they are assigned the same score under the original CEAP, while the revision is able to differentiate between them.

The CEAP score is not designed as a clinical dossier, but it gives an instantaneous image of a clinical condition, which however is not suitable to follow the evolution of CVI. The shunt classification is another theoretical framework useful to the comprehension of chronic venous diseases. The advanced terms of CEAP are not in conflict with the shunt classification, while they could be only complementary points of view.

This work started from a debate on the Vasculab message list. From the discussion the need of a new revision appeared clear. A decision was made to undertake an On Line CEAP survey, which is still in progress. The results will be available in the near future and we hope they will be useful to guide any eventual official revision.