[Surgical management of peripheral vascular disease in patients with severe coronary artery disease: importance of operative concept to reconstruct catheter insertion route for PTCA or CABG].
We discussed the operative concept of revascularization of lower extremities in patients associated with severe, coronary artery disease (CAD). Those with symptomatic CAD may undergo coronary artery bypass (CABG) or percutaneous coronary angioplasty (PTCA) with or without intraaortic balloon pump (IABP). Special attention should be paid during operation in these patients in order to reconstruct the arterial catheter route, which gives us the best way to percutaneous transfemoral approach to the aorta or the coronary arteries. One should not choose arbitrarily extra-anatomical bypass, such as axillo-femoral or femorofemoral, in these cases. Also, artificial graft should not be applied in the common femoral arteries, which will make percutaneous approach difficult. Common femoral arteries, if needed, are best reconstructed by means of thromboendarterectomy. Attaining smooth, bilateral aorto-ilio-femoral continuity is the main goal of revascularization of lower extremities in patients with CAD.
Ochi
M
M
Department of Cardiovascular Surgery, Aizu Central Hospital.
Terada
K
K
Yamauchi
H
H
Ikeshita
M
M
Tanaka
S
S
Shoji
T
T
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D002406:Catheterization, Peripheral / Q000379:methods; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications / Q000628:therapy*; D005260:Female; D005263:Femoral Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D014652:Vascular Diseases / Q000150:complications / Q000601:surgery*