The risk for myocardial ischemia is primarily determined by the maximal and current coronary artery Z scores.
Additional clinical findings associated with a long-term risk for myocardial ischemia:
(1) flow stasis (associated with greater length and distal location of aneurysms)
(2) multiple aneurysms
(3) multiple branches affected
(4) presence of luminal irregularities
(5) calcifications and/or luminal myofibroblastic proliferation
(6) impaired arterial vasodilation
(7) impaired flow reserve
(8) absent or suboptimal of collateral vessels
(9) history of a revascularization procedure
(10) history of coronary artery thrombosis
(11) history of myocardial infarction
(12) presence of ventricular dysfunction
