Peripheral arterial disease classification

Peripheral arterial disease Microchapters
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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 arterial disease is commonly divided in the Fontaine stages, introduced by Dr René Fontaine in 1954. A more recent classification by Rutherford consists of three grades and six categories. In addition, the American College of Cardiology/American Heart Association (ACC/AHA) uses a symptoms-based classification (absence of symptoms, claudication, critical limb ischemia and acute limb ischemia) in their guidelines.

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)

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

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

• Absence of symptoms
• Claudication
• Critical/chronic limb ischaemia
• Acute limb ischaemia

References

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