VSG Cardiac Risk Index | Carotid Endarterectomy

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Use the Vascular Study Group of New England Cardiac Risk Index (VSG-CRI) to estimate post-operative in-hospital major cardiac event after a carotid endarterectomy.

Diabetes
Coronary Artery Disease? [Definition]
Prior coronary revascularization (CABG or PCI)?
Congestive heart failure?
Cardiac Stress Test [Definition]
Aspirin use? [Definition]
Clopidogrel use? [Definition]
Statin use? [Definition]
Prior vascular surgery? [Definition]

Definitions:


Coronary artery disease includes a history of MI but no symptoms, or stable angina, or unstable angina or MI < 6 months ago.
Cardiac stress test includes stress EKG, stress echo or nuclear stress scans within 2 years of surgery.
ASA use would be selected if aspirin taken within 36 hours of surgery.
Clopidogrel use would be selected if clopidogrel taken within 36 hours of surgery.
Statin use would be selected if a statin taken within 36 hours of surgery.

Select prior vascular surgery if known history of previous arterial bypass. Previous arterial bypass includes:

  • Any non-cardiac arterial bypass for occlusive disease.
  • Previous arterial carotid endarterectomy.
  • Any known true arterial aneurysm repair (excluding cerebral or pseudo-aneurysm).
  • PTA/stent of any non-cardiac artery.

Prior Vascular surgery also includes major amputation of the hand or foot.

 

About this calculator

The Revised Cardiac Risk Index (RCRI) is a widely used model for predicting cardiac events after noncardiac surgery. However, it substantially underestimates in-hospital cardiac events in patients undergoing elective or urgent vascular surgery, especially after lower extremity bypass, endovascular abdominal aortic aneurysm repair and open infrarenal abdominal aortic aneurysm repair. The Vascular Study Group of New England Cardiac Rsk Index (VSG-CRI) more accurately predicts in-hospital cardiac events after vascular surgery.

Citations

This model was adapted from
Bertges DJ, Goodney PP, Zhao Y, Schanzer A, Nolan BW, Likosky DS, Eldrup-Jorgensen J, Cronenwett JL; The Vascular Study Group of New England Cardiac Risk Index (VSG-CRI) predicts cardiac complications more accurately than the Revised Cardiac Risk Index in vascular surgery patients, Vascular Study Group of New England. J Vasc Surg. 2010 Jun 4; 52 (1):5-12.