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.