Peripheral artery disease (PAD) affects more than 200 million patients worldwide and chronic limbthreatening
ischemia (CLTI) is the most advanced stage of PAD with very high morbidity and mortality rates.
Cardiovascular medicine is trending towards a more personalized approach where each individual patient will
be managed according to specific risk factors, disease characteristics, expectations related to their disease and
individualized assessment of potential outcomes. For this reason, a number of risk models and scores have
been developed during the last few years. Our aim in this comprehensive review article is to provide an overview
of selected risk models and scores for patients with PAD and CLTI. Given that some of the published
scores were of low quality (minimal discriminatory ability), we included scores that were already externally
validated or scores that had promising initial findings.
Available scoring systems were grouped in the five following categories according to their utility: i) scores that
can detect asymptomatic patients who should be screened for PAD, ii) scores for assessment of functional status
and quality of life in patients with PAD, iii) scores assessing risk for amputation and other major adverse limb
events among patients with CLTI, iv) scores for the optimal revascularization strategy in each patient and
scores predicting successful procedural outcomes; v) scores predicting short or long-term cardiovascular and
limb related outcomes after either revascularization or at least angiographic assessment. Limitations of available
scoring systems include development and validation in specific populations, lack of external validation (for
some of them) and also lack of synchrony with current era endovascular technology. However, with further optimization
of current scores and the development of new scores, the field of PAD and CLI can be transitioned to
a personalized medicine approach.