Peripheral arterial disease classification: Difference between revisions

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{{Peripheral arterial disease}}
{{Peripheral arterial disease}}


{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}
{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}, [[User:Rim Halaby|Rim Halaby]]


==Overview==
==Overview==
Peripheral artery occlusive disease is commonly divided in the Fontaine stages, introduced by Dr René Fontaine in 1954<ref>{{cite journal | author=Fontaine R, Kim M, Kieny R | title=Die chirugische Behandlung der peripheren Durchblutungsstörungen. (Surgical treatment of peripheral circulation disorders) | journal=Helvetica Chirurgica Acta | year=1954 | volume=21 | issue=5/6 | pages=499&ndash;533 | language=German | pmid=14366554}}</ref>
Peripheral artery occlusive disease is commonly divided in the Fontaine stages, introduced by Dr René Fontaine in 1954<ref name="Fontaine">{{cite journal | author=Fontaine R, Kim M, Kieny R | title=Die chirugische Behandlung der peripheren Durchblutungsstörungen. (Surgical treatment of peripheral circulation disorders) | journal=Helvetica Chirurgica Acta | year=1954 | volume=21 | issue=5/6 | pages=499&ndash;533 | language=German | pmid=14366554}}</ref>
==Classification==
==Classification==
===Fontaine Stages===
===Fontaine Stages===
Peripheral artery occlusive disease is commonly divided in the Fontaine stages, introduced by Dr René Fontaine in 1954:<ref>{{cite journal | author=Fontaine R, Kim M, Kieny R | title=Die chirugische Behandlung der peripheren Durchblutungsstörungen. (Surgical treatment of peripheral circulation disorders) | journal=Helvetica Chirurgica Acta | year=1954 | volume=21 | issue=5/6 | pages=499&ndash;533 | language=German | pmid=14366554}}</ref>
* Stage I: asymptomatic
* Stage I: asymptomatic
* Stage II a: mild [[claudication]]
* Stage II a: mild [[claudication]]
* Stage II b: moderate to severe [[claudication]] for relatively shorter distances  
* Stage II b: moderate to severe [[claudication]] for relatively shorter distances  
* Stage III: ischemia rest pain
* Stage III: ischemia rest pain
* Stage IV: ulceration or [[biological tissue|tissue]] loss ([[gangrene]])
* Stage IV: ulceration or [[biological tissue|tissue]] loss ([[gangrene]])<ref name="Fontaine">{{cite journal | author=Fontaine R, Kim M, Kieny R | title=Die chirugische Behandlung der peripheren Durchblutungsstörungen. (Surgical treatment of peripheral circulation disorders) | journal=Helvetica Chirurgica Acta | year=1954 | volume=21 | issue=5/6 | pages=499&ndash;533 | language=German | pmid=14366554}}</ref>


===Rutherford Categories===
===Rutherford Categories===
Line 22: Line 21:
* Grade II, Category 4: ischaemia rest pain
* Grade II, Category 4: ischaemia rest pain
* Grade III, Category 5: minor tissue loss
* Grade III, Category 5: minor tissue loss
* Grade IV, Category 6: major tissue loss.
* Grade IV, Category 6: major tissue loss.<ref>Christopher W. Advances in interventional cardiology. Circulation                                        November 6, 2007                                                                                                          vol. 116                                                                        no. 19                                                                        2203-2215</ref>


;Shown below is an image showing the difference between Fontaine's and Rutherford's classification.
;Shown below is an image showing the difference between Fontaine's and Rutherford's classification.

Revision as of 14:21, 31 October 2012

Peripheral arterial disease Microchapters

Home

Patient Information

Overview

Classification

Pathophysiology

Causes

Differentiating Peripheral arterial disease from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Guidelines for Management

Case Studies

Case #1

AHA/ACC Guidelines on Management of Lower Extremity PAD

Guidelines for Clinical Assessment of Lower Extremity PAD

Guidelines for Diagnostic Testing for suspected PAD

Guidelines for Screening for Atherosclerotic Disease in Other Vascular Beds in patients with Lower Extremity PAD

Guidelines for Medical Therapy for Lower Extremity PAD

Guidelines for Structured Exercise Therapy for Lower Extremity PAD

Guidelines for Minimizing Tissue Loss in Lower Extremity PAD

Guidelines for Revascularization of Claudication in Lower Extremity PAD

Guidelines for Management of CLI in Lower Extremity PAD

Guidelines for Management of Acute Limb Ischemial in Lower Extremity PAD

Guidelines for Longitudinal Follow-up for Lower Extremity PAD

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Rim Halaby

Overview

Peripheral artery occlusive disease is commonly divided in the Fontaine stages, introduced by Dr René Fontaine in 1954[1]

Classification

Fontaine Stages

  • Stage I: asymptomatic
  • Stage II a: mild claudication
  • Stage II b: moderate to severe claudication for relatively shorter distances
  • Stage III: ischemia rest pain
  • Stage IV: ulceration or tissue loss (gangrene)[1]

Rutherford Categories

  • Grade 0, Category 0: asymptomatic
  • Grade I, Category 1: mild claudication
  • Grade I, Category 2: moderate claudication
  • Grade I, Category 3: severe claudication
  • Grade II, Category 4: ischaemia rest pain
  • Grade III, Category 5: minor tissue loss
  • Grade IV, Category 6: major tissue loss.[2]
Shown below is an image showing the difference between Fontaine's and Rutherford's classification.
Classification of PAD

Classification Used in American College of Cardiology/American Heart Association (ACC/AHA) Practice Guidelines

  • Asymptomatic
  • Claudication
  • Critical limb ischaemia
  • Acute limb ischaemia

References

  1. 1.0 1.1 Fontaine R, Kim M, Kieny R (1954). "Die chirugische Behandlung der peripheren Durchblutungsstörungen. (Surgical treatment of peripheral circulation disorders)". Helvetica Chirurgica Acta (in German). 21 (5/6): 499&ndash, 533. PMID 14366554.
  2. Christopher W. Advances in interventional cardiology. Circulation November 6, 2007 vol. 116 no. 19 2203-2215


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