An aortic aneurysm involving the infrarenal aorta should be carefully described prior to considering an endovascular repair. The Ad Hoc Committee for Standardized Reporting Practices in Vascular Surgery of the Society for Vascular Surgery and International Society for Cardiovascular Surgery has specified the appropriate terms to use.
Parameters:
(1) clinical presentation
(2) greatest mural diameter of the aneurysm as seen on the CT scan (taken horizontally across the aneurysm) in centimeters
(3) extent of aneurysm involvement (the proximal neck is the distance from the inferior edge of the renal arteries to the aneurysm; the distal neck is the distance from the inferior edge of the aneurysm to the aortic bifurcation)
(4) tortuosity of the aorta (maximum angle seen when traversing the entire length of the aneurysm; a perfectly straight aorta is reported as 180°)
(5) anatomy of the iliac arteries, occlusive disease severe enough to require intervention prior to introduction of the endovascular carrier system
(6) anatomy of the iliac arteries, tortuosity severe enough to require intervention prior to introduction of the endovascular carrier system
|
Parameter |
Finding |
Term |
|
clinical presentation |
asymptomatic |
Stage I |
|
|
intact but symptomatic |
Stage II |
|
|
contained rupture |
Stage III |
|
|
free rupture |
Stage IV |
|
greatest mural diameter |
< 5 cm |
small |
|
|
5 - 6.5 cm |
medium |
|
|
> 6.5 cm |
large |
|
extent of aneurysm |
length of proximal neck >= 1.5 cm; length of distal neck >= 1.0 cm |
Grade I |
|
|
length of proximal neck >= 1.5 cm; length of distal neck < 1.0 cm |
Grade II |
|
|
length of proximal neck < 1.5 cm; length of distal neck >= 1.0 cm |
Grade III |
|
|
length of proximal neck < 1.5 cm; length of distal neck < 1.0 cm |
Grade IV |
|
tortuosity |
180° to 150° |
Grade I |
|
|
150° to 120° |
Grade II |
|
|
< 120° |
Grade III |
|
anatomy of iliac arteries, occlusive disease |
absent |
A |
|
|
present |
B |
|
anatomy of iliac arteries, tortuosity |
nontortuous |
N |
|
|
tortuous |
T |
Specialty: Cardiology
