Clinical classification and treatment of acute limb ischemia (based on the Rutherford classification)

Table 3.19-4. Clinical classification and treatment of acute limb ischemia (based on the Rutherford classification)
Grade/category	Prognosis	Clinical features		Treatment
Grade/category	Prognosis	Sensory loss	Motor deficit	Treatment
I. Viable	Not immediately threatened	None	None	Thrombolysis or surgery
II. Threatened
– IIa. Marginally	Salvageable if promptly treated	None or minimal (toes)	None	Thrombolysis or surgery
– IIb. Immediately	Salvageable if promptly revascularized	More than toes	Mild or moderate	Surgery, may be combined with thrombolysis
III. Irreversible	Inevitable high-level amputation or permanent nerve damage	Profound, anesthetic	Profound, paralysis (rigor)	Primary amputation in the case of prolonged ischemic time with low likelihood of improvement and high risk of revascularization; early (6-8 h) embolectomy or thrombectomy may be considered to determine the extent of reversibility or to improve the level of amputation
Adapted from J Vasc Surg. 1997;26(3):517-38 and Eur Heart J. 2011;32(22):2851-906.