Rutherford · Vascular

Rutherford classification of peripheral arterial disease

vigente

Categorizes chronic limb ischemia severity.

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Escala de categorias

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Procedência e vigência

Órgão emissor: Vascular consensus
Versão: 1997
Ano: 1997
Família: léxico
Tipo de lógica: flat
Modalidade: Angiography
Fonte primária: Classification of chronic limb ischemia (Fontaine and Rutherford)
Última verificação: 2026-06-26
Última checagem: 2026-06-26

Lógica de decisão

Forma estruturada (flat). Uma futura calculadora a lê; as categorias abaixo são a superfície legível.

Mostrar a lógica estruturada (JSON)

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  "categories": [
    "0",
    "1",
    "2",
    "3",
    "4",
    "5",
    "6"
  ]
}

Categorias num relance

Cat.	Significado	Conduta	Risco	Fonte
0	Category 0, asymptomatic Asymptomatic chronic lower-limb ischemia; no claudication, rest pain or tissue loss. Disease may be detectable only objectively (e.g. reduced ankle-brachial index) without functional symptoms.	Risk-factor modification only: smoking cessation, statin and antiplatelet therapy, control of diabetes/hypertension. No revascularization indicated for the asymptomatic state.	Benign limb prognosis; only about 1-3% of claudicants per year progress to critical limb-threatening ischemia, and asymptomatic disease progresses even more slowly. Cardiovascular (MI/stroke) risk drives overall mortality.	okfonte Wikipedia 'Peripheral artery disease', Classification section (Rutherford category 0, 'asymptomatic'); management and progression rate from StatPearls 'Peripheral Arterial Disease' (NBK430745), Treatment and Prognosis sections (lifestyle/medical first-line; '1% to 3% per year progress to critical limb ischemia').
1	Category 1, mild claudication Mild intermittent claudication: reproducible ischemic muscle pain on exertion that does not markedly limit walking. Corresponds clinically to mild PAD (ankle-brachial index roughly 0.70-0.90).	First-line conservative therapy: supervised exercise/walking program, smoking cessation and pharmacologic risk-factor control (statin, antiplatelet); cilostazol may improve walking distance.	Stable claudication carries a low limb-loss risk; roughly 1-3% of claudicants per year progress to critical limb ischemia. Major risk is cardiovascular mortality, not amputation.	okfonte Wikipedia 'Peripheral artery disease', Classification section (category 1, 'mild claudication'); ABI band, conservative therapy and progression rate from StatPearls NBK430745 (mild PAD ABI 0.70-0.90; first-line lifestyle/exercise/pharmacologic; 1-3%/yr to CLI).
2	Category 2, moderate claudication Moderate intermittent claudication: exertional ischemic limb pain of intermediate severity, between categories 1 and 3. Corresponds clinically to moderate PAD (ankle-brachial index roughly 0.50-0.70).	Supervised exercise therapy and medical risk-factor optimization remain first-line; endovascular or surgical revascularization is reserved for lifestyle-limiting symptoms refractory to conservative measures.	Low annual risk of progression to limb-threatening ischemia (about 1-3% per year); prognosis dominated by concurrent coronary/cerebrovascular disease.	okfonte Wikipedia 'Peripheral artery disease', Classification section (category 2, 'moderate claudication'); moderate-PAD ABI band and management/progression from StatPearls NBK430745 (ABI 0.50-0.70; exercise first-line, revascularization for refractory cases).
3	Category 3, severe claudication Severe intermittent claudication: markedly walking-limiting exertional ischemic pain that does not yet occur at rest. Most severe claudication grade before the critical-ischemia categories.	Conservative therapy continues, but lifestyle-limiting severe claudication refractory to exercise/medical therapy is an indication for revascularization (endovascular angioplasty/stenting or bypass surgery).	Still primarily a quality-of-life rather than limb-threat problem; overall progression of claudication to critical limb ischemia remains roughly 1-3% per year.	okfonte Wikipedia 'Peripheral artery disease', Classification section (category 3, 'severe claudication'); revascularization-for-refractory-claudication and progression rate from StatPearls NBK430745 (endovascular/bypass for refractory disease).
4	Category 4, rest pain Ischemic rest pain: continuous pain at rest from inadequate perfusion, classically in the forefoot/toes, worse when supine and relieved by dependency. Marks the onset of chronic limb-threatening ischemia (ankle-brachial index typically under 0.50; low ankle/toe pressures).	Limb-threatening ischemia: urgent revascularization (endovascular or surgical bypass) to relieve pain and salvage the limb, with aggressive risk-factor and wound/foot care; medical therapy alone is insufficient.	Chronic limb-threatening ischemia carries a high amputation risk of roughly 25-40% at 1 year together with markedly elevated cardiovascular mortality.	okfonte Wikipedia 'Peripheral artery disease', Classification section (category 4, 'rest pain'); CLTI threshold, revascularization need and amputation risk from StatPearls NBK430745 (ABI <0.50 = severe PAD/CLTI; 'risk of amputation is about 25% to 40% at 1 year').
5	Category 5, minor tissue loss Minor tissue loss: ischemic ulceration or focal gangrene limited to the digits/forefoot, not extending beyond a non-healing toe ulcer. A form of chronic limb-threatening ischemia.	Limb-threatening ischemia requiring prompt revascularization for wound healing and limb salvage, combined with local wound care/debridement, infection control and risk-factor optimization.	Limb-threatening ischemia with high 1-year amputation risk (about 25-40%) and high cardiovascular mortality; tissue loss further worsens limb prognosis versus rest pain alone.	okfonte Wikipedia 'Peripheral artery disease', Classification section (category 5, 'minor tissue loss; ischemic ulceration not exceeding ulcer of the digits'); CLTI management and 1-year amputation risk from StatPearls NBK430745.
6	Category 6, major tissue loss Major tissue loss: extensive ischemic ulceration or frank gangrene extending above the transmetatarsal level, beyond salvageable digits, often with non-viable foot tissue. The most advanced category of chronic limb-threatening ischemia.	Urgent revascularization for any salvageable tissue, but extensive necrosis often necessitates major (below- or above-knee) amputation; aggressive infection control and risk-factor management throughout.	Worst limb prognosis with the highest likelihood of major amputation (overall CLTI amputation risk about 25-40% at 1 year, greatest with extensive tissue loss) and very high cardiovascular mortality.	okfonte Wikipedia 'Peripheral artery disease', Classification section (category 6, 'major tissue loss; severe ischemic ulcers or frank gangrene'); CLTI management and amputation risk from StatPearls NBK430745.

Referências cruzadas

fronteira compartilhadaFontaine. Fontaine classification of peripheral arterial diseaseFiner-grained alternative to Fontaine staging.

Histórico de versões

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