Percutaneous peripheral interventions in patients with multivessel coronary artery disease

Background: Coronary artery disease (CAD) is often accompanied by peripheral artery disease. There are patients who are disqualified from surgical approach in the treatment of limb ischaemia due to many comorbidities including severe CAD. Aim: To examine whether multilevel intervention (peripheral and coronary) in patients with multi-vessel CAD (MVD) carries a higher in-hospital and long-term risk in comparison to patients with a single vessel disease (SVD). Methods: Data on consecutive patients with peripheral artery disease and CAD (acute coronary syndrome) were gathered in our department from January 2003 till June 2009. All patients included in the study had peripheral and coronary angioplasty performed during the same index hospital stay. Patients were divided into two groups: those with SVD and those with MVD in coronary angiography. Results: There were 116 patients included in the study - 56 patients in the SVD group and 60 patients in the MVD group. The frequency of major adverse cerebrovascular and cardiac events during long-term follow up tended to be higher in patients with MVD, however the difference did not reach statistical significance (MVD vs SVD: 13.3% vs 3.6%, p = 0.061). There were significantly more major adverse peripheral events such as repeat percutaneous transluminal angioplasty, stroke//transient ischaemic attack and lower limb amputation in the MVD group than in the SVD patients (20% vs 1.8%, p = 0.002). Conclusions: Percutaneous angioplasty of lower limb arteries in patients with MVD seems to be an effective and relatively safe method of treatment of patients with disseminated atherosclerosis and an alternative to surgical treatment.