Fallacies and Possible Remedies of the SYNTAX Score
Table 2
Differences and similarities with respect to criteria and definitions between the SYNTAX score and CatLet score.
Items
Values
Calculators
CatLet score
SYNTAX score
1. Underlying mechanism
Weighted matrix#
Leaman score
2. Dominance selection
RCA dominance
6 types
2 types
Dx size
3 types
NA
LAD length
3 types
NA
3. Lesion definition
As in the SYNTAX
≥50% diameter stenosis on vessels >1.5 mm
4. Multiplication factor
As in the SYNTAX
5.0 for occlusion 2.0 for nonocclusion
5. Lesion types
6 types
2 types
Native nonocclusion (50–99% diameter reduction)
Yes
Yes
Native acute total occlusion (ATO)
Yes
Yes
Native chronic total occlusion (CTO)
Yes
Yes
In-stent nonocclusion
Yes
NA
In-stent ATO
Yes
NA
In-stent CTO
Yes
NA
6. Scoring modification
Yes if appropriate
No
7. Culprit vessels
Indicated
No
8. Trifurcation
Yes/no
Scored
9. Bifurcation
Yes/no
Scored
10. Aorta ostial lesion
Yes/no
Scored
11. Severe tortuosity
Yes/no
Scored
12. Length >20 mm
Yes/no
Scored
13. Heavy calcification
Yes/no
Scored
16. Thrombus
Yes/no
Scored
17. Diffuse disease/small vessels
Discarded
Scored
Notes: CatLet = Coronary Artery Tree description and Lesion EvaluaTion; SYNTAX = Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery; RCA = right coronary artery; LAD = left anterior descending artery; Dx = diagonals; NA = not available. #See reference [16].