Rutherford Becker Classification System

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.

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.

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

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.

This Rutherford Becker classification system is based on the clinical and objective criteria

Clinical Categories of Chronic Limb Ischemia (Rutherford Becker Classification System)

00Asymptomatic, not hemodynamically significantNormal treadmill/stress test
I1Mild claudicationCompletes treadmill test, ankle pressure after exercise <25-50 mm Hg less than blood pressure
2Moderate claudicationBetween categories 1 and 3
3Severe claudicationCannot complete treadmill test, ankle pressure after exercise <50 mm Hg
II4Ischemic rest painResting ankle pressure <40 mm Hg, flat or barely pulsatile ankle or metatarsal pulse volume recording, toe pressure <30 mm Hg
5Minor tissue loss: nonhealing ulcer, focal gangrene with diffuse pedal edemaResting ankle pressure <60 mm Hg, flat or barely pulsatile ankle metatarsal pulse volume recording, toe pressure <40 mm Hg
III6Major tissue loss: extending above transmetatarsal level, functional foot no longer salvageableSame as category 5

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