Clinical Presentation
Applied
Type
ModificationConfidence
90%
Created
Mar 19, 2026
Evidence
2 sources
Rationale
The section was updated to incorporate the 2025 ACC Scientific Statement on PAD in diabetes, which reinforces the clinical utility of WIfI staging. Additionally, content from Raskin et al. (2025) was added to link clinical staging with value-based imaging practices. Redundant text in the original description of WIfI was also corrected for better readability.
Evidence
Content Changes
removedadded
Risk stratification and staging systems guide clinical decision-making in chronic limb-threatening ischemia (CLTI). The Wound, Ischemia, and foot Infection (WIfI) (Wound, Ischemia, foot Infection) classification grades limb threat and estimates amputation risk and revascularization benefit.benefit, Thea GLASSstrategy (Globalemphasized by the American College of Cardiology (ACC) for the management of patients with diabetes to optimize limb salvage [@mills2014, @acc2025-b]. The Global Limb Anatomic Staging System)System (GLASS) stages anatomic complexity of femoropopliteal and infrapopliteal disease. The PLAN framework (Patient risk, Limb severity [WIfI], ANatomic complexity [GLASS]) integrates these systems to guide revascularization strategy selection, conduit choice, and perfusion targets [@mills2014,[@conte2019]. @conte2019].Systematic clinical staging is also critical for value-based medicine to ensure the appropriate allocation of imaging resources and minimize diagnostic misallocation [@raskin2025].