Simultaneous revascularization for complex brachiocephalic and coronary artery disease.

We have recently encountered two patients with significant coronary artery disease in addition to complex and extensive brachiocephalic occlusive disease. Both were operated upon successfully with simultaneous repair of both anatomic areas. These cases form the basis of this article. Fourteen additional patients with combined coronary and conventional carotid disease have been operated upon successfully with a simultaneous approach to both lesions. We conclude, until convincing prospective data are available possibly indicating otherwise, that a simultaneous approach to these combined lesions is indicated.