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Patient ID: ...................................


Name : ...................................
Date of birth: ...................................

SYNTAX Score I

All answers

1. Dominance right
2. Number of lesions 6

lesion 1
3. segment numbers involved 1
4. Total occlusion No
I. Most proximal segment number Skipped
II. More than 3 months Skipped
III. Blunt stump Skipped
IV. Bridging Skipped
V. the first segment beyond the T.O. visualized by contrast: Skipped
VI. Sidebranch Skipped
5. Trifurcation No
6. Bifurcation No
Bifurcation angulation Skipped
7. Aorto Ostial lesion Yes
8. Severe Tortuosity No
9. Length >20 mm No
10. Heavy calcification No
11. Thrombus No
Comment

lesion 2
3. segment numbers involved 2
4. Total occlusion No
I. Most proximal segment number Skipped
II. More than 3 months Skipped
III. Blunt stump Skipped
IV. Bridging Skipped
V. the first segment beyond the T.O. visualized by contrast: Skipped
VI. Sidebranch Skipped
5. Trifurcation No
6. Bifurcation No
Bifurcation angulation Skipped
7. Aorto Ostial lesion Skipped
8. Severe Tortuosity Yes
9. Length >20 mm Yes
10. Heavy calcification Yes
11. Thrombus No
Comment

lesion 3
3. segment numbers involved 3
4. Total occlusion Yes
I. segment numbers 3
I. Most proximal segment number 3
II. More than 3 months yes
III. Blunt stump yes
IV. Bridging no

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V. the first segment beyond the T.O. visualized by contrast: 4
Yes, both sidebranches
VI. Sidebranch <1.5mm and >=1.5mm
are involved
5. Trifurcation No
6. Bifurcation No
Bifurcation angulation Skipped
7. Aorto Ostial lesion Skipped
8. Severe Tortuosity Yes
9. Length >20 mm Skipped
10. Heavy calcification Yes
11. Thrombus No
Comment

lesion 4
3. segment numbers involved 7
4. Total occlusion No
I. Most proximal segment number Skipped
II. More than 3 months Skipped
III. Blunt stump Skipped
IV. Bridging Skipped
V. the first segment beyond the T.O. visualized by contrast: Skipped
VI. Sidebranch Skipped
5. Trifurcation No
6. Bifurcation Yes: Medina 0,1,1
Bifurcation angulation yes
7. Aorto Ostial lesion Skipped
8. Severe Tortuosity No
9. Length >20 mm Yes
10. Heavy calcification No
11. Thrombus No
Comment

lesion 5
3. segment numbers involved 9
4. Total occlusion No
I. Most proximal segment number Skipped
II. More than 3 months Skipped
III. Blunt stump Skipped
IV. Bridging Skipped
V. the first segment beyond the T.O. visualized by contrast: Skipped
VI. Sidebranch Skipped
5. Trifurcation No
6. Bifurcation No
Bifurcation angulation Skipped
7. Aorto Ostial lesion Skipped
8. Severe Tortuosity No
9. Length >20 mm Yes
10. Heavy calcification No
11. Thrombus No
Comment

lesion 6
3. segment numbers involved 12a
4. Total occlusion No
I. Most proximal segment number Skipped
II. More than 3 months Skipped
III. Blunt stump Skipped
IV. Bridging Skipped
V. the first segment beyond the T.O. visualized by contrast: Skipped
VI. Sidebranch Skipped

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5. Trifurcation No
6. Bifurcation Yes: Medina 0,0,1
Bifurcation angulation yes
7. Aorto Ostial lesion Skipped
8. Severe Tortuosity Yes
9. Length >20 mm No
10. Heavy calcification No
11. Thrombus No
Comment

Diffuse disease/Small vessels


Segments selected No

TOTAL SYNTAX SCORE I: 41

MACCE by SYNTAX Score 33+

The cumulative MACCE rate is displayed for the SYNTAX Trial group this score
corresponds to.

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