Taylor et al developed the Lower Extremity Grading System (LEGS) score. This can help to grade chronic lower extremity ischemia and to help guide management. The authors are from Greenville Hospital System and Clemson University in South Carolina.
Patient selection: chronic lower extremity ischemia
Parameters:
(1) arteriographic findings
(2) presentation
(3) functional status
(4) comorbidities
(5) technical factors
|
Parameters |
Finding |
Points |
|---|---|---|
|
iliac artery disease by arteriography |
Iliac TASC A |
8 |
|
|
Iliac TASC B |
8 |
|
|
Iliac TASC C |
2 |
|
|
Iliac TASC D |
0 |
|
|
no TASC lesion |
0 |
|
femoral-popliteal-tibial occlusion |
femoral-popliteal-tibial occlusion with < 5 cm occlusion or stenosis |
5 |
|
|
femoral-popliteal-ilial occlusion with >= 5 cm occlusion or stenosis with distal target |
0 |
|
|
femoral-popliteal-ileal occlusion with >= 5 cm occlusion or stenosis without distal target |
6 |
|
|
no femoral-popliteal-ilial occlusion |
0 |
|
presentation |
claudication |
5 |
|
|
limb threatening ischemia |
2 |
|
|
none |
0 |
|
functional status |
ambulatory |
0 |
|
|
ambulatory at home only |
2 |
|
|
non-ambulatory transfer only |
5 |
|
|
non-ambulatory |
20 |
|
obesity |
absent |
0 |
|
|
present |
2 |
|
high risk coronary artery disease (CAD) |
absent |
0 |
|
|
present |
3 |
|
age in years |
<= 70 years |
0 |
|
|
71 to 80 |
1 |
|
|
> 80 years |
2 |
|
redo |
no |
0 |
|
|
yes |
2 |
|
blind segment target |
no |
0 |
|
|
yes |
2 |
|
venous conduit |
present |
0 |
|
|
absent |
6 |
|
|
absent with foot infection |
8 |
arteriographic subscore =
= MAX(points for iliac arteriography, points for femoral-popliteal-iliac arteriography)
comorbidity subscore =
= (points for obesity) + (points for CAD) + (points for age in years)
technical factor subscore =
= (points for redo) + (points for blind segment target) + (points for venous conduit)
total LEGS score =
= (arteriographic subscore) + (points for presentation) + (points for functional status) + (comorbidity subscore) + (technical factor subscore)
Interpretation:
• minimum score: 0
• maximum score: 52
|
Total Score |
Recommended Therapy |
|---|---|
|
0 to 9 |
open surgery |
|
10 to 19 |
endovascular surgery |
|
>= 20 |
primary amputation |
Specialty: Cardiology
ICD-10: ,
