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What is the Rutherford Becker classification system?
This is a classification system for chronic limb ischemia.
Critical limb ischemia (CLI) is a clinical syndrome of ischemic pain at rest or tissue loss, such as nonhealing ulcers or gangrene, related to peripheral artery disease.
Critical limb ischemia (CLI) may be considered the most severe pattern of peripheral artery disease (PAD), being associated with a high risk of major amputation, cardiovascular events and death.
CLI has a high short-term risk of limb loss and cardiovascular events. Noninvasive or invasive angiography help determine the feasibility and approach to arterial revascularization.
A mortality rate of 20% within 6 months after the diagnosis and 50% at 5 years has been reported.
Critical limb ischemia (CLI) is considered the most severe pattern of peripheral artery disease.
It is defined by the presence of chronic ischemic rest pain, ulceration or gangrene attributable to the occlusion of peripheral arterial vessels.
It is popular in the United States.
This Rutherford Becker classification system is based on the clinical and objective criteria
The Fontaine and Rutherford Systems have been used to classify risk of amputation and likelihood of benefit from revascularization by subcategorizing patients into two groups: ischemic rest pain and tissue loss.
Clinical Categories of Chronic Limb Ischemia (Rutherford Becker Classification System)
| GRADE | CATEGORY | CLINICAL DESCRIPTION | OBJECTIVE CRITERIA |
|---|---|---|---|
| 0 | 0 | Asymptomatic, not hemodynamically significant | Normal treadmill/stress test |
| I | 1 | Mild claudication | Completes treadmill test, ankle pressure after exercise <25-50 mm Hg less than blood pressure |
| 2 | Moderate claudication | Between categories 1 and 3 | |
| 3 | Severe claudication | Cannot complete treadmill test, ankle pressure after exercise <50 mm Hg | |
| II | 4 | Ischemic rest pain | Resting ankle pressure <40 mm Hg, flat or barely pulsatile ankle or metatarsal pulse volume recording, toe pressure <30 mm Hg |
| 5 | Minor tissue loss: nonhealing ulcer, focal gangrene with diffuse pedal edema | Resting ankle pressure <60 mm Hg, flat or barely pulsatile ankle metatarsal pulse volume recording, toe pressure <40 mm Hg | |
| III | 6 | Major tissue loss: extending above transmetatarsal level, functional foot no longer salvageable | Same as category 5 |
