Criteria

Venous Clinical Severity Score​​[18]

Each clinical feature is given a score of 0 (none), 1 (mild), 2 (moderate), or 3 (severe), depending on its severity. The total score is calculated to determine the overall severity of clinical disease present.

[Figure caption and citation for the preceding image starts]: Revised Venous Clinical Severity ScoreAdapted from Vasquez MA et al. J Vasc Surg 2010 Nov;52(5):1387-96; used with permission [Citation ends].com.bmj.content.model.Caption@1b9e5718

Pain or other discomfort (i.e., aching, heaviness, fatigue, burning, soreness; presumes venous origin)

  • Occasional pain or other discomfort, not restricting regular daily activities: 1 point

  • Daily pain or other discomfort; interfering with, but not preventing, regular daily activities: 2 points

  • Daily pain or discomfort, limits more regular daily activities: 3 points

Varicose veins (≥3 cm in standing position)

  • Few: scattered (i.e., isolated branch varicosities or clusters; also includes corona phlebectatica [ankle flare]): 1 point

  • Confined to calf or thigh: 2 points

  • Involves calf and thigh: 3 points

Venous oedema (presumes venous origin)

  • Limited to foot and ankle area: 1 point

  • Extends above ankle but below knee: 2 points

  • Extends to knee and above: 3 points

Skin pigmentation (presumes venous origin; does not include focal pigmentation over varicose veins or pigmentation due to other chronic diseases)

  • None or focal: 0 points

  • Limited to perimalleolar area: 1 point

  • Diffuse over lower third of calf: 2 points

  • Wider distribution above lower third of calf: 3 points

Inflammation (more than just recent pigmentation; i.e., erythema, cellulitis, venous eczema, dermatitis)

  • Limited to perimalleolar area: 1 point

  • Diffuse over lower third of calf: 2 points

  • Wider distribution above lower third of calf: 3 points

Induration (presumes venous origin of secondary skin and subcutaneous changes, i.e., chronic oedema with fibrosis, hypodermitis; includes white atrophy and lipodermatosclerosis)

  • Limited to perimalleolar area: 1 point

  • Diffuse over lower third of calf: 2 points

  • Wider distribution above lower third of calf: 3 points

Active ulcer number

  • 0: 0 points

  • 1: 1 point

  • 2: 2 points

  • ≥3: 3 points

Active ulcer duration (longest active)

  • Not applicable: 0 points

  • <3 months: 1 point

  • >3 months but <1 year: 2 points

  • Not healed for >1 year: 3 points

Active ulcer size (largest active)

  • Not applicable: 0 points

  • Diameter <2 cm: 1 point

  • Diameter 2-6 cm: 2 points

  • Diameter >6 cm: 3 points

Use of compression therapy

  • Not used: 0 points

  • Intermittent use of stockings: 1 point

  • Wears stockings most days: 2 points

  • Full compliance with stockings: 3 points

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