vascular

Venous Clinical Severity Score (VCSS)

Quantifies severity of chronic venous disease using 10 attributes (revised VCSS, American Venous Forum 2010). Designed to measure change over time and after treatment.

Pain or other discomfort (aching, heaviness, fatigue, soreness, burning) — presumed venous*

Varicose veins (≥ 3 mm diameter, standing)*

Venous oedema (presumed venous)*

Skin pigmentation (presumed venous; not focal pigmentation over varicose veins)*

Inflammation (erythema, cellulitis, venous eczema, dermatitis — more than recent pigmentation)*

Induration (chronic oedema with fibrosis, hypodermitis; includes atrophie blanche and lipodermatosclerosis)*

Active ulcers — number*

Active ulcer duration (longest active)*

Active ulcer size (largest active)*

Use of compression therapy*

Score interpretation

VCSS Total (0–30) 0–30

Revised VCSS: higher = more severe chronic venous disease. There are no validated severity cut-offs — use the score to track change over time and after treatment.

→ Interpret with the CEAP class and duplex findings; repeat after treatment to measure the response. Venous ulcer or skin changes: refer to a vascular service (NICE CG168).

Interpretation bands for the VCSS. Apply clinical judgement and local guidance.

References

Curated clinical cross-links plus same-class fallbacks.

Calculators

CEAP Classification — Chronic Venous Disease · Venous Disease

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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