The Rutherford classification system evaluates chronic limb ischemia by categorizing a patient's condition based on clinical description and objective criteria provided by the user. The system then assigns a specific grade and category to each input based on a predefined classification scale.

The classification criteria are:

1. Asymptomatic: If an individual is asymptomatic, indicating there is no significant occlusive disease, and they have normal results on a treadmill or stress test, this is classified as "Grade 0, Category 0."

2. Mild Claudication: Individuals who experience mild claudication and can complete a treadmill exercise, where ankle pressure after exercise is greater than 50 mmHg but at least 20 mmHg lower than the resting value, are classified as "Grade 0, Category 1."

3. Moderate Claudication: When the condition falls between the asymptomatic and severe claudication categories, with objective values between those two, it is classified as "Grade I, Category 2."

4. Severe Claudication: If an individual cannot complete a standard treadmill exercise and their ankle pressure after exercise is less than 50 mmHg, it is classified as "Grade I, Category 3."

5. Ischemic Rest Pain: This condition is characterized by resting ankle pressure below 40 mmHg, with flat or barely detectable ankle or metatarsal pulse volume recording and toe pressure below 30 mmHg, resulting in a classification of "Grade II, Category 4."

6. Minor Tissue Loss: In cases where there is nonhealing ulceration or focal gangrene with diffuse pedal ischemia, and resting ankle pressure is under 60 mmHg, with a flat or barely pulsatile ankle or metatarsal pulse volume recording and toe pressure below 40 mmHg, the classification is "Grade III, Category 5."

7. Major Tissue Loss: When tissue loss extends above the transmetatarsal level and the functional foot is no longer salvageable, along with resting ankle pressure under 60 mmHg, similar pulse volume characteristics, and toe pressure below 40 mmHg, it is classified as "Grade III, Category 6."

The Rutherford Classification of Chronic Limb Ischemia is a clinical scoring system used to categorize the severity of peripheral arterial disease (PAD) in patients. This classification system is particularly applicable to patients with symptoms of chronic limb ischemia, a condition characterized by insufficient blood flow to the limbs due to narrowing or blockage of the arteries.

The Rutherford Classification system is useful in guiding treatment decisions and predicting prognosis. It categorizes chronic limb ischemia into seven stages (0-6), ranging from asymptomatic (0) to major tissue loss or gangrene (6). Each stage is defined by specific clinical symptoms, such as claudication, rest pain, and ulceration or gangrene.

There are no specific exclusion criteria for the use of the Rutherford Classification. However, it may not be as useful in patients with acute limb ischemia, or in those with non-atherosclerotic causes of limb ischemia. It is also less applicable in patients with PAD who do not have symptoms of chronic limb ischemia.

Rutherford classification of chronic limb ischemia