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[Clinical-functional classification of combined occlusive lesions of the arterial system]
Insights
The HBVL classification system categorizes arterial insufficiency into four functional basins: heart, brain, visceral, and lower extremities. This system aids in assessing vascular conditions and guiding treatment strategies for patients.
Area of Science:
- Vascular Medicine
- Cardiovascular Surgery
- Clinical Assessment
Context:
- The clinical assessment of the vascular system is complex.
- Existing methods may not fully capture the functional status of arterial circulation.
- A standardized approach is needed for effective diagnosis and treatment planning.
Purpose:
- To introduce a novel clinico-functional classification system for the arterial vascular system.
- To propose the HBVL (Heart, Brachiocephalic, Visceral, Lower extremities) classification for appraising arterial insufficiency.
- To establish criteria for grading arterial stenosis severity within functional vascular basins.
Summary:
- The HBVL classification divides the arterial system into four functional basins: coronary (Heart), brachiocephalic (Brain), visceral, and lower extremities.
- Each basin is assigned a functional class (0-4) indicating the severity of arterial insufficiency, from no stenosis (0) to decompensated circulation (3-4).
- This system provides a comprehensive overview of arterial circulation and aids in determining patient treatment tactics.
Impact:
- The HBVL classification offers a practical tool for clinicians to evaluate vascular health.
- It facilitates a more precise understanding of arterial stenosis and its functional impact.
- The classification aids in tailoring treatment strategies, potentially improving patient outcomes.
Abstract:
For a complex approach to the clinico-functional appraisal of the vascular system the authors suggest dividing the arterial system into 4 conventional functional basins: the coronary region (1), the brachiocephalic (2), the visceral (3), and the arterial basin of the lower extremities. In accordance with the 4 distinguished anatomo-functional vascular basins, the classification is designated by their first letters: HBVL, where H stands for the heart, B for the brain, V for the visceral vessels, and L for the lower extremities. Next to each letter is shown the functional class of arterial insufficiency of the vascular basin. The figure 0 denotes the absence of arterial stenosis. All the other figures from 1 to 4 reflect the functional severity of arterial insufficiency. The 1st functional class is characterized by the absence of a clinical picture of the disease in arterial stenosis, the 2nd class by the stage of subcompensation of circulation, and the 3rd and 4th classes by decompensation of circulation. The criteria for separating the degree of ischemia into functional classes are suggested. The HBVL classification is a working one because it not only illustrates and indicates fully the condition of arterial circulation in the vessels of the region but determines the tactics of treatment of the patient. The possibilities of the classification are illustrated by concrete clinical cases.