Aortic Aneurysm Endovascular Planning Tool

Aortic Neck

Neck diameter mm

Neck length mm

Infrarenal angle °

Suprarenal angle °

Circumferential thrombus / significant calcification at neck

Conical / reverse-taper neck morphology

Aneurysm & Access

Max aneurysm diameter mm

Access vessel diameter mm

Iliac Fixation Zone

R common iliac diam mm

L common iliac diam mm

Shorter iliac seal-zone length mm

Device eligibility — ranked by IFU fit

enter anatomy to screen

Within IFU standalone On-label only via a named adjunct device Outside IFU Awaiting input

Scope: Infrarenal bifurcated endografts for standard EVAR only — Gore EXCLUDER / EXCLUDER Conformable, Medtronic Endurant II/IIs, Cook Zenith Flex / Zenith Alpha (Low Profile), Endologix AFX2 / Ovation Alto, Terumo Aortic TREO. Fenestrated, branched, EVAS, aorto-uni-iliac, TEVAR, and iliac-branch configurations are out of scope. Criteria sourced from each manufacturer's current published Instructions for Use and FDA Summary of Safety & Effectiveness Data, retrieved August 2026; IFUs are revised periodically. This is an inclusion screen, not an exclusion filter — every device is shown with the specific parameter(s) driving its status, so a device outside IFU on one measurement but reasonable on all others remains visible for surgeon judgment rather than being silently dropped. Amber ("on-label via adjunct") status means the standalone graft is off-label on the entered anatomy but a named adjunct device (e.g., Heli-FX EndoAnchor implants with Endurant) has its own FDA-approved combined indication that covers it — the card explains exactly what that requires. Cost fields describe structural cost drivers (piece count, delivery-system complexity, consumables) from published comparative literature, not actual prices — net device cost is confidential and set by hospital/GPO contract.

Infrarenal Seal Zone

Seal zone length mm

Diameter mm

Angle to AAA axis °

Angle to suprarenal aorta °

>10% diameter increase over the proximal 15 mm of neck (conical neck)

Circumferential thrombus/calcification at implantation sites

Proximal Thoracoabdominal Landing (if suprarenal/juxtarenal/thoracoabdominal)

Proximal neck diameter mm

Proximal seal length mm

Angle at proximal seal zone °

Only needed for the off-the-shelf branched pathways below (t-Branch, TAMBE) — the custom-fenestrated pathway above uses the infrarenal seal zone instead.

Visceral Branch Vessels (TAMBE pathway only)

Renal artery diameter mm

Celiac/SMA diameter mm

Branch seal zone length (renal/SMA/celiac) mm

Brachial/axillary access inadequate

Iliac Fixation

Iliac diameter mm

Iliac seal length mm

Device eligibility — ranked by IFU fit

enter anatomy to screen

Within IFU Outside IFU Awaiting input

Scope: Complex AAA repair for short infrarenal neck (4–<15 mm) or juxtarenal/suprarenal/thoracoabdominal anatomy — Cook Zenith Fenestrated (ZFEN, custom-made, up to 3 fenestrations), Cook Zenith t-Branch (off-the-shelf, 4-branch), and GORE EXCLUDER Thoracoabdominal Branch Endoprosthesis (TAMBE, off-the-shelf, 4-branch, FDA-approved 2024). This is the least complete module in this tool. The much larger real-world category of physician-modified endografts (PMEGs), other custom fenestrated/branched designs, and chimney/snorkel (parallel graft) techniques are not modeled here — anatomy landing outside all three devices below very often still has an endovascular option through one of those routes at a specialized aortic center, which this screen cannot capture. Treat an "outside IFU" result here as "needs specialist complex-aortic referral for a fuller options discussion," not as "no endovascular option exists." Criteria sourced from Cook Medical and Gore Medical IFU documents and FDA PMA filings, retrieved August 2026.

Proximal Landing Zone

Diameter mm

Length mm

Distal Landing Zone

Diameter mm

Length mm

Arch Branch (TBE pathway only)

Proximal segment length mm

Proximal covered length mm

Segment length = distal edge of the branch vessel (e.g. LSA) to the midpoint of the next proximal branch. Covered length = same starting point to that next branch's distal ostial edge. Only relevant to the TBE branched pathway below — the other four devices don't use these.

Access & Landing Zone Quality

Access vessel diameter mm

Landing zone is aneurysmal, dissected, heavily calcified, or heavily thrombosed

Repair requires left subclavian artery (LSA) coverage

Device eligibility — ranked by IFU fit

enter anatomy to screen

Within IFU Outside IFU Awaiting input

Scope: TEVAR for descending thoracic aortic aneurysm, isolated lesion, Type B dissection, or single-branch arch repair — Gore TAG Conformable, Medtronic Valiant Navion, Cook Zenith Alpha Thoracic, Terumo Aortic Relay/RelayPro, and Gore TAG Thoracic Branch Endoprosthesis (TBE) for cases requiring preserved flow into one arch branch. Multi-branch/fenestrated arch devices, the Gore Ascending Stent Graft, ascending aorta repair, and traumatic transection-specific sizing remain out of scope. Criteria sourced from manufacturer IFU pages, FDA PMA filings, and clinical trial protocols, retrieved August 2026. This is an inclusion screen, not an exclusion filter. LSA coverage, when flagged, is noted on every device card — for the four non-branched devices it's a revascularization-planning prompt; for TBE it's the indication itself.

Glasgow Aneurysm Score

Age years

Preoperative shock (hemodynamic instability at presentation)

Myocardial disease (prior MI and/or ongoing angina)

Cerebrovascular disease (any prior stroke or TIA)

Renal disease (chronic/acute renal failure, urea >20 mmol/L or creatinine >150 µmol/L)

Planned procedure

Score & interpretation

Enter age and risk factors to calculate.

What this score is and isn't

The Glasgow Aneurysm Score (GAS) was derived and validated primarily in ruptured AAA open-repair cohorts as a predictor of perioperative mortality; a score >95 has been reported as a threshold for high surgical mortality risk in that setting. Its discriminative performance is more limited (AUC ≈ 0.69–0.70) in the endovascular era and in elective repair, and it has NOT been validated as a stand-alone tool for elective operative decision-making. Use it as one data point alongside ASA class, frailty assessment, cardiopulmonary reserve, and surgeon/team judgment — not as a substitute for any of them.

Formula: GAS = age (years) + 17 (shock) + 7 (myocardial disease) + 10 (cerebrovascular disease) + 14 (renal disease). An updated variant adds +7 for open surgical repair (vs. +0 for endovascular repair) to account for procedure-related risk difference. Sourced from Samy, Murray & MacBain (1994, original derivation), Korhonen et al. (Br J Surg 2004, ruptured AAA validation), and endovascular-era validation studies, retrieved August 2026 — see references below.

Why this section links out instead of calculating

The SVS VQI risk calculators (VQI-CRI, the VQI TEVAR mortality score, and the VQI-RAI frailty index) run on multivariable logistic-regression models trained on the VQI registry. Their exact coefficients are not published as a simple point table the way GAS and VSG-CRI are — they're delivered live through vqi.org and the QxMD "Calculate" app. Reproducing them here without the real coefficients would mean guessing at a clinical risk model, so instead this section describes what each calculator covers and links to the authoritative source.

VQI Cardiac Risk Index (VQI-CRI)

Predicts in-hospital postoperative myocardial infarction (POMI)

Procedure-specific calculators for: carotid endarterectomy, infrainguinal bypass, suprainguinal bypass, endovascular AAA repair (infrarenal only, excludes ruptured), and open AAA repair (infrarenal only, excludes ruptured/suprarenal/thoracoabdominal). Derived from 88,791 VQI procedures; all-procedure model AUC 0.75.

Known predictor variables (all-procedure model)

Age, operation type, coronary artery disease, congestive heart failure, diabetes, creatinine >1.8 mg/dL, preoperative stress-test result, and body mass index.

Baseline POMI incidence by procedure: CEA 0.8%, EVAR 1.0%, infrainguinal bypass 2.6%, suprainguinal bypass 3.1%, open AAA repair 4.3%.

VQI TEVAR Mortality Risk Score

Predicts 30-day mortality after TEVAR for intact descending thoracic aneurysm

Derived from 2,110 VQI TEVAR patients (2014–2020); overall 30-day mortality in the derivation cohort was 4.1%. Uses ASA class and other preoperative variables; available as a QxMD Calculate app tool.

VQI Risk Analysis Index (VQI-RAI) — frailty

Frailty screen, not a mortality/cardiac calculator

Component variables: sex, age, BMI, renal failure, congestive heart failure, dyspnea, preoperative ambulation, and functional status. A VQI-RAI score ≥35 has been used to define frailty (roughly the most at-risk 12% of the VQI AAA-repair population), which independently predicts long-term mortality after both open and endovascular AAA repair.

Aortic Neck

Aneurysm & Access

Iliac Fixation Zone

Device eligibility — ranked by IFU fit

Reference list

General / comparative sources

General outcomes evidence — hostile/wide/angulated neck, on- vs. off-IFU repair

Infrarenal Seal Zone

Proximal Thoracoabdominal Landing (if suprarenal/juxtarenal/thoracoabdominal)

Visceral Branch Vessels (TAMBE pathway only)

Iliac Fixation

Device eligibility — ranked by IFU fit

Proximal Landing Zone

Distal Landing Zone

Arch Branch (TBE pathway only)

Access & Landing Zone Quality

Device eligibility — ranked by IFU fit

Glasgow Aneurysm Score

Score & interpretation

VSGNE Cardiac Risk Index (VSG-CRI)

Score & interpretation