SYNTAX Score (Simplified)

Coronary Anatomical Complexity — Revascularization Strategy Guidance

Left Main disease ≥ 50% stenosis of the left main coronary artery

Proximal LAD lesion ≥ 70% stenosis proximal to first diagonal

+3.5

Bifurcation lesion(s) Lesion involving a significant side branch ≥ 1.5 mm

Heavy calcification Severe vessel calcification visible on angiography

Vessel tortuosity ≥ 2 bends > 75° or 1 bend > 90° proximal to lesion

Lesion length > 20 mm Diffuse disease or long segment stenosis

Thrombus present Visible thrombus on angiography

Aorto-ostial lesion Lesion within 3 mm of the aorta

Small vessel disease Reference diameter < 2.5 mm with ≥ 70% stenosis

Diseased segments (≥ 70% stenosis, ≥ 50% LM)

segments

Each segment adds ~1.5 points (max 16 coronary segments)

Number of CTOs

CTOs

Each CTO adds +5 points

SYNTAX Score 0

Complexity Category Low (0–22)

Low complexity — PCI and CABG are equivalent options