A 65-year-old woman with severe chronic limb-threatening ischemia (CLTI) has an ankle-brachial index (ABI) of 0.3. Angiography shows a 15 cm occlusion of the superficial femoral artery. TASC II classification categorizes this lesion as:

• A TASC A — suitable for endovascular treatment
• B TASC B — endovascular preferred
• C TASC C — surgery preferred ✓
• D TASC D — surgery recommended

Explanation

TASC II classification of femoropopliteal lesions: Type A — single stenosis <10 cm or occlusion <5 cm; Type B — multiple lesions or single stenosis 10–15 cm or occlusion ≤15 cm; Type C — multiple stenoses/occlusions totalling >15 cm or recurrent lesions after two interventions; Type D — complete CFA or SFA occlusion, or complete popliteal occlusion. A 15 cm SFA occlusion falls at the boundary of Type B/C; in TASC II, single SFA occlusion 5–15 cm is Type B, while those >15 cm or complex disease favor surgery (Type C/D). This 15 cm occlusion is TASC B/C borderline, but many classify exactly 15 cm single SFA occlusion as TASC C, preferring surgical bypass in CLTI.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.