Related Experiment Video
Updated: Jul 8, 2026
Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
Published on: September 22, 2020
[Diagnostic and therapeutic strategy in patients with multiple arterial disease]
1Service de Cardiologie, Hôpital de la Salpêtrière, Paris.
Insights
Patients needing peripheral surgery often have coronary artery disease. Coronary lesions significantly impact prognosis, with long-term risks outweighing immediate surgical dangers. Careful, individualized assessment is key.
Area of Science:
- Cardiovascular Medicine
- Vascular Surgery
- Interventional Cardiology
Context:
- Concomitant coronary and peripheral arterial lesions are frequently observed, particularly in patients undergoing peripheral surgical procedures.
- Coronary artery disease significantly influences the overall prognosis, overshadowing the immediate risks associated with peripheral surgery.
- The long-term risks associated with combined coronary and peripheral lesions are substantially greater than the acute operative risks.
Purpose:
- To evaluate the diagnostic and therapeutic strategies for patients presenting with concomitant coronary and peripheral arterial disease.
- To emphasize the importance of comprehensive arterial assessment during both peripheral and coronary interventions.
- To guide clinical decision-making regarding multifocal revascularization procedures.
Summary:
- Clinical data guides the diagnostic approach, with non-invasive investigations offering limited discriminatory value for coronary evaluation.
- Routine invasive investigations are not recommended; diagnostic strategies should be tailored to individual patient profiles.
- Indications for simultaneous or sequential multifocal revascularization (surgical or percutaneous) are limited and require case-by-case consideration.
Impact:
- Highlights the critical role of coronary artery disease in determining prognosis for patients with peripheral vascular disease.
- Advocates for a judicious, individualized approach to diagnosis and treatment, prioritizing patient factors like age and comorbidities.
- Underscores the need for careful consideration of risks versus benefits when planning revascularization strategies in complex multifocal arterial disease.
Abstract:
Concomitant coronary and peripheral lesions are common, in particular in candidates for peripheral surgery. Coronary lesions dominate the prognosis in all cases. The later mid- and long-term risks of such associations is far greater than the immediate operative risk. Each type of surgery, peripheral or coronary, offers the opportunity for arterial evaluation of the other area in its own right, rather than because of the surgical context. No invasive investigations should be routine. The diagnostic approach is guided by clinical data and to a lesser degree by non-invasive investigations, the discriminant nature of which is unfortunately poor in the context of coronary evaluation. Indications for multifocal simultaneous or sequential revascularization procedures, by surgery or angioplasty, are in fact small in number. They are wide ranging and must be discussed case by case, taking into account age, general condition, the emergency context and the type and severity of lesions.
More Related Videos
10:28Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
13:48Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound
Published on: April 21, 2023
Related Concept Videos
01:27Coronary Artery Disease V: Interprofessional Care
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
01:26Atherosclerosis III: Management
01:23Atherosclerosis IV: Nursing Management
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:27Peripheral Artery Disease III: Interprofessional Care