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Fontaine Classification of Peripheral Arterial Disease

Four-stage European staging of chronic lower-limb ischaemia (Fontaine 1954). Complements Rutherford. Used in ESVS guidance.

Score interpretation

Stage I — Asymptomatic 0

→ Modify cardiovascular risk: smoking cessation, statin, antiplatelet (clopidogrel preferred), BP and glycaemic control.

Stage II — Intermittent claudication 1–2

→ Best medical therapy + supervised exercise programme (NICE CG147). Endovascular revascularisation if lifestyle-limiting after ≥3 months.

Stages III–IV — Chronic limb-threatening ischaemia 3–4

→ Urgent vascular referral (≤2 weeks per ESVS 2024). ABPI/TBI, duplex, CTA. Revascularisation; analgesia; wound care; consider WIfI staging and amputation MDT if unsalvageable.

Interpretation bands for the Fontaine PAD. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.