SVS co-morbidity score

Score                                                Description of score

Major components

Cardiac status

0                       Asymptomatic, with normal electrocardiogram

1                        Asymptomatic but with either remote myocardial infarction by                                                                 history (6 months), occult myocardial infarction by electrocardiogram, or                                      fixed defect on dipyridamole thallium or similar scan

2                        Any one of the following: stable angina, no angina but significant reversible                                  perfusion defect on dipyridamole thallium scan, significant silent ischemia                                  (1% of time) on Holter monitoring, ejection fraction 25% to 45%, controlled                                   ectopy or asymptomatic arrhythmia, or history of congestive heart failure that                              is now well compensated

3                      Any one of the following: unstable angina, symptomatic or poorly controlled                                  ectopy/arrhythmia (chronic/recurrent), poorly compensated or recurrent                                        congestive heart failure, ejection fraction less than 25%, myocardial infarction                            within 6 months

Pulmonary status

0                        Asymptomatic, normal chest radiograph, pulmonary function tests within 20%                             of predicted

1                         Asymptomatic or mild dyspnea on exertion, mild chronic parenchymal                                        radiograph changes, pulmonary function tests 65% to 80% of predicted

2                         Between 1 and 3

3                        Vital capacity less than 1.85 L, FEV1 less than 1.2 L or less than 35% of                                     predicted, maximal voluntary ventilation less than 50% of predicted, PCO2                                  greater than 45 mm Hg, supplemental oxygen use medically necessary, or                                  pulmonary hypertension

Renal status

0                        No known renal disease, normal serum creatinine level

1                        Moderately elevated creatinine level, as high as 2.4 mg/dL (212

2                        Creatinine level, 2.5 to 5.9  (522) mg/dL

3                        Creatinine level greater than 6.0 mg/dL, or on dialysis or with kidney                                            transplant

Minor components

Hypertension

0                        None (cutoff point, diastolic pressure usually lower than 90 mm Hg)

1                         Controlled (cutoff point, diastolic pressure usually lower than 90 mm Hg) with                              single drug

2                         Controlled with two drugs

3                          Requires more than two drugs or is uncontrolled

Age

0                            55 y

1                            55-69 y

2                            70-79 y

3                             80 y

 

 

Risk factor Weighting Score

Cardiac                     x4            12

Pulmonary                 x2             6

Renal                         x2             6

Hypertension              x1              3

Age                           x1              3

Maximum score*                      30

 

Morphologic state

Definition, grading, and categorization of an initial morphologic state

Attribute      Absent 0          Mild 1            Moderate 2         Severe 3

Aortic neck

Length (L) L>25 mm    15< L <25 mm    10 <L<15 mm    L <10 mm

Diameter (d) d <24 mm 24<d<26 mm 26<d<28 mm d<28 mm

Angle 150° 150° angle 135° 135° angle 120° Angle 120°

Calcification/thrombus 25% 25-50% 50% –

Aortic aneurysm

Angulation and tortuosity

Aortic tortuosity index (T) T 1.05 1.05 T 1.15 1.15 T 1.2 T 1.2

Aortic angle ( ) 160° to 180° 140° to 159° 120° to 139° 120°

Thrombus 0 25% 25%-50% 50%

Aortic branch vessels No vessels 1 lumbar/IMA 2 vessels 2 vessels

d 4 mm IMA d 4 mm

Pelvic perfusion Patent bilateral IIA Single IIA occlusion Single IIA occlusion Bilateral IIA occlusion Contralateral IIA 50% stenosis

Iliac artery

Calcification None 25% vessel length 25%-50% vessel length 50% vessel length

Diameter/occlusive disease

d 10 mm 8 d 10 mm 7 d 8 mm d 7 mm

No occlusive disease No stenosis 7 mm diameter or 3 cm long

Focal stenosis 7 mm diameter and 3 cm in length

Stenosis 7 mm diameter and 3 cm in length More than one focal stenosis 7 mm diameter

Angulation and tortuosity

Iliac tortuosity index (
)
1.25 1.25
1.5 1.5
1.6
1.6 Iliac angle () 160° to 180° 121° to 159° 90° to 120° 90°

Iliac artery sealing zone

Length (L) L 30 mm20 L30 mm10 L20 mm L 10 mm

Diameter (d) d 12.5 mm 12.5 d 14.5 mm 14.5 d 17 mm d 17 mm

IIA, Internal iliac artery; IMA, inferior mesenteric artery.