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Table 4. Clinical Subsets of Patients With PAD
Clinical
Subset Description/Characterization
CLTI • Severe clinical subset of PAD.
• Among patients with known PAD, incidence of CLTI estimated to
be between 11% and 20%.
• Manifests as ischemic rest pain, nonhealing wounds/ulcers, or
gangrene with symptoms present for >2 wk.
• Responsible for most major and minor limb amputations related to PAD.
• Historically estimated 1-y mortality rate of 25%–35% and 1-y rate of
amputation up to 30% among patients presenting with CLTI.
• Lower rates of mortality and amputation reported in a recent RCT of
patients with CLTI undergoing revascularization.
• Ischemic rest pain often affects the forefoot and is worsened with limb
elevation and relieved by dependency.
• Among vascular specialists, the Fontaine and Rutherford classification
systems are most commonly used to categorize severity of CLTI.
• The WIf I classification estimates risk of lower extremity amputation
according to wound extent, severity of ischemia, and presence of foot
infection and has been shown to correlate with clinical outcomes.
(cont'd)
