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Categorias
Reescritas a partir da fonte e citadas
I
1 de 5
Stage I, asymptomatic
Asymptomatic stage — peripheral arterial disease is present but the patient has no symptoms.
CondutaCardiovascular risk-factor management: smoking cessation, statin and antiplatelet therapy, and control of diabetes/hypertension; no revascularization for the asymptomatic limb itself.
RiscoUp to ~50% of people with PAD are asymptomatic; even without limb symptoms, PAD marks elevated cardiovascular risk (stroke and myocardial infarction).
verificadoClassification of chronic limb ischemia (Fontaine and Rutherford)Wikipedia 'Peripheral artery disease', Classification section (Fontaine stage I 'asymptomatic') and Treatment/Prognosis sections (risk-factor management; ~50% asymptomatic; elevated stroke/MI risk).
IIa
2 de 5
Stage IIa, mild claudication
Mild intermittent claudication — claudication pain that comes on after walking more than 200 metres.
CondutaSmoking cessation and supervised exercise therapy (treadmill walking ~30-60 min, at least 3x/week) plus risk-factor control; first-line for claudication, with revascularization usually reserved for lifestyle-limiting or refractory symptoms.
RiscoClaudication is relatively benign for the limb — over ~5 years only ~7% undergo bypass, ~4% major amputation, ~16% worsen — but systemic risk is high (estimated ~30% 5-year mortality from cardiovascular events).
verificadoClassification of chronic limb ischemia (Fontaine and Rutherford)Wikipedia 'Peripheral artery disease', Classification section (Fontaine IIa, claudication >200 m) and Treatment/Prognosis sections (supervised exercise 30-60 min 3x/week; 7% bypass, 4% amputation, 16% worsening; ~30% 5-year mortality).
IIb
3 de 5
Stage IIb, moderate to severe claudication
Moderate-to-severe intermittent claudication — claudication pain that comes on after walking less than 200 metres.
CondutaAs for IIa — smoking cessation, supervised exercise therapy and risk-factor control are first-line; revascularization (endovascular or bypass) is considered for lifestyle-limiting or exercise-refractory short-distance claudication.
RiscoStill a claudication (non-limb-threatening) stage with limb-outcome and ~30% 5-year cardiovascular mortality figures shared with IIa, though shorter pain-free distance reflects more severe disease.
verificadoClassification of chronic limb ischemia (Fontaine and Rutherford)Wikipedia 'Peripheral artery disease', Classification section (Fontaine IIb, claudication <200 m) and Treatment/Prognosis sections (exercise therapy/smoking cessation first-line; claudication-cohort outcomes and ~30% 5-year mortality).
III
4 de 5
Stage III, rest pain
Ischemic rest pain — pain in the limb at rest, without exertion.
CondutaPart of chronic limb-threatening (critical) ischemia: revascularization is appropriate (endovascular or surgical bypass, with bypass recommended where life expectancy exceeds ~2 years), alongside analgesia and risk-factor management.
RiscoCritical limb ischemia / limb-threat category — clear risk of limb loss if adequate perfusion is not re-established.
verificadoClassification of chronic limb ischemia (Fontaine and Rutherford)Wikipedia 'Peripheral artery disease', Classification section (Fontaine III 'rest pain') and Treatment sections on chronic limb-threatening/critical limb ischemia (revascularization, bypass if life expectancy >2 years; risk of limb loss).
IV
5 de 5
Stage IV, ulceration or gangrene
Tissue loss — ulceration or gangrene of the affected limb.
CondutaCritical limb ischemia with tissue loss: urgent revascularization to salvage the limb plus wound care; amputation may be required when gangrene is established or revascularization fails.
RiscoHighest-risk stage for limb loss — established gangrene/tissue death and infection often necessitate amputation.
verificadoClassification of chronic limb ischemia (Fontaine and Rutherford)Wikipedia 'Peripheral artery disease', Classification section (Fontaine IV 'ulcers or gangrene') and Treatment sections (revascularization vs amputation; amputation when gangrene established).