Beven E G
J Vasc Surg. 1986 Apr;3(4):682-4. doi: 10.1067/mva.1986.avs0030682.
Between 1978 and 1982, 1000 patients under consideration for peripheral vascular reconstruction underwent coronary angiography. Normal coronary arteries were found in 8%; mild to moderate coronary artery disease (CAD), in 32%; advanced but compensated CAD, in 29%; severe correctable CAD, in 25%; and inoperable CAD, in 6%. Severe correctable CAD was demonstrated in 14% of patients who had no indications of CAD on clinical criteria. Patients with severe correctable CAD were advised to undergo myocardial revascularization before the vascular operation. Under this protocol, a total of 1292 cardiac and peripheral vascular reconstructions were performed with an overall mortality rate of 2.6% (5.2% for myocardial revascularization and 2% for vascular operation). Only one death (0.8%) occurred after peripheral vascular reconstruction in 130 patients who had preliminary myocardial revascularization. These results indicate that approximately 30% of all patients who require vascular reconstruction have severe, but surgically correctable, CAD and that preliminary myocardial revascularization appears to add a margin of safety to the subsequent vascular operation.
1978年至1982年间，1000名考虑接受外周血管重建术的患者接受了冠状动脉造影。结果发现，冠状动脉正常的患者占8%；轻度至中度冠状动脉疾病（CAD）患者占32%；重度但可代偿性CAD患者占29%；重度可纠正性CAD患者占25%；不可手术的CAD患者占6%。在临床标准未显示CAD迹象的患者中，14%被证明患有重度可纠正性CAD。建议患有重度可纠正性CAD的患者在进行血管手术前接受心肌血运重建术。按照该方案，共进行了1292例心脏和外周血管重建手术，总死亡率为2.6%（心肌血运重建术为5.2%，血管手术为2%）。在130例已先行心肌血运重建术的患者中，仅1例（0.8%）在外周血管重建术后死亡。这些结果表明，所有需要血管重建术的患者中，约30%患有重度但可手术纠正的CAD，先行心肌血运重建术似乎为随后的血管手术增加了安全边际。
