Clinical Experience and Outcomes in ASV Reflux Treatment: A 20-Month Single Center Analysis

analysis has assumed the leading role in the assessment of CVI in everyday clinical practice.Methods: All details of the CEAP classification were analyzed by a multidisciplinary European panel and compared with current scientific work.The results were sorted by patient-related relevance using artificial intelligence (AI) software (A.I.M., Veinbrain).Results: Invasive therapy indications for CVI today result from pathophysiology ("P"), which is primarily recognized in ultrasound examinations.The venous valve status is decisive for early stages; the hemodynamic status and the pathological mechanisms (pressure, congestion) as well as progression modes for later stages.Regardless of the "C" stage, the focus of current treatment is always on normalizing hemodynamics as far as possible and preserving all tissue substance.The "P" therefore comes first in terms of importance, inseparably followed by the "A" of anatomy.The clinical manifestation "C" is of relevance just for a secondary part of the therapy, such as textile compression, skin treatment, or aesthetic measures.Preclinical stages are unknown to CEAP and must now be added.Instead of the etiology (formerly "E," now part of "P"), "Ego & Environment" ("E") is recommended to classify the type of patient (physiognomy, movement patterns, history, cultural environment) for international comparability.Conclusions: The CEAP classification is a formerly meritorious but outdated classification.As CEAP is blind to the true pathophysiology and especially its early stages, it delays prevention and cost-effective, preferably vein-preserving early therapies.CEAP must either be redesigned or creatively replaced.