Table 3.18-4. Clinical classification and treatment of acute limb ischemia (based on the Rutherford classification)

Grade/category

Prognosis

Clinical features

Treatment

Sensory loss

Motor deficit

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

Adapted from J Vasc Surg. 1997;26(3):517-38 and Eur Heart J. 2011;32(22):2851-906.