Peripheral Artery Disease: Classification

Peripheral arterial disease (pAVD) can be classified according to Fontaine as follows:

Stage Symptoms
I Asymptomatic
IIa Complaint-free walking distance > 200 m
IIb Complaint-free walking distance < 200 m
IIc Lesions (injuries) without the presence of critical ischemia (reduced blood flow)
III Ischemic pain at rest
IV Trophic (nutritional) lesions such as necrosis (dead tissue), ulceration (ulceration), gangrene (special form of coagulation necrosis; it occurs after prolonged relative or absolute ischemia (reduced blood flow) and is caused by necrosis)

Notice: Stage I may also include patients identified by a decreased ABI (ankle-brachial index) who have severe vascular disease. These are patients in whom the ability to walk is severely limited due to frailty, heart failure, neuropathy, etc. This subgroup is referred to as masked LEAD according to the new terminology.Modified Fontaine Classification for Clinical Stages of Lower Extremity Occlusive Disease (LEAD).

Stage Symptoms
I Asymptomatic
IIa Non-disabling intermittent claudication (intermittent claudication)
IIb disabling intermittent claudication
III Ischemic pain at rest
IV Trophic (nutritional) lesions such as necrosis (dead tissue), ulceration (ulceration), gangrene (special form of coagulation necrosis; it occurs after prolonged relative or absolute ischemia (reduced blood flow) and is caused by necrosis)

Peripheral arterial disease (pAVD) can be classified according to Rutherford as follows:

Stage Symptoms
0 Asymptomatic
1 Minor intermittent claudication
2 Moderate intermittent claudication
3 Severe intermittent claudication
4 Ischemic pain at rest
5 Distal (positional designation facing outward from body trunk) trophic (nutritional) lesions/small necrosis
6 Proximal (positional designation meaning located toward the body or extending toward the body) trophic disorders extending above the metatarsal level (metatarsal bone) trophic lesions/large necrosis