Institute of Cardiology, Collegium Medicum, Jagiellonian University, Kraków, Poland.
Kardiol Pol. 2010 Oct;68(10):1115-21.
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.
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).
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.
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).
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.
冠心病（CAD）常伴有外周动脉疾病。由于许多合并症，包括严重 CAD，许多患者因手术禁忌而不能接受肢体缺血的治疗。
检查多血管 CAD（MVD）患者的多水平干预（外周和冠状动脉）与单血管疾病（SVD）患者相比是否具有更高的住院期和长期风险。
从 2003 年 1 月至 2009 年 6 月，在我院收集了连续患有外周动脉疾病和 CAD（急性冠状动脉综合征）的患者的数据。所有纳入研究的患者在同一住院期间均进行外周和冠状动脉血管成形术。患者被分为两组：冠状动脉造影显示 SVD 患者和 MVD 患者。
本研究共纳入 116 例患者，其中 SVD 组 56 例，MVD 组 60 例。在长期随访中，MVD 患者的主要不良心脑血管事件发生率较高，但差异无统计学意义（MVD 与 SVD：13.3%与 3.6%，p=0.061）。MVD 组的主要不良外周事件（如再次经皮腔内血管成形术、中风/短暂性脑缺血发作和下肢截肢）明显多于 SVD 患者（20%比 1.8%，p=0.002）。
MVD 患者下肢动脉经皮血管成形术似乎是一种治疗弥散性动脉粥样硬化患者的有效且相对安全的方法，可替代手术治疗。
