The CEAP classification, introduced by the American Venous Forum, is the accepted standard for grading chronic venous disease. the four elements of the CEAP classification include: clinical symptoms, etiology, anatomy, and pathophysiology The clinical symptoms are classified from mild to severe: C0 no clinical symptoms Cl cobweb-like varicose veins C2 varicose veins (serpentine varicose changes) C3 edema without skin changes C4 skin changes C5 skin changes with healing Ulceration C6 Skin changes with active ulcers