Extended atherosclerotic lesion in a patient with multimorbidity: the surgeon’s view. Clinical case and historical note

Authors: Alshibaya M.D.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Case reports

DOI: https://doi.org/10.24022/1997-3187-2021-15-4-534-546

For citation: Alshibaya M.D. Extended atherosclerotic lesion in a patient with multimorbidity: the surgeon’s view. Clinical case and historical note. Creative Cardiology. 2021; 15 (4): 534–46 (in Russ.). DOI: 10.24022/1997-3187-2021-15-4-534-546

Received / Accepted:  23.08.2021 / 10.12.2021

Keywords: multifocal atherosclerosis comorbidity multimorbidity simultaneous revascularization of brain and heart

Full text:  



Multifocal atherosclerosis is a common medical term that implies the presence of clinically and/or hemodynamically significant lesions of 2 or more arterial territories in one patient. The most clinically important variant of multifocal atherosclerotic lesion is the combined pathology of the coronary and brachiocephalic areas potentially dangerous by the development of life-threatening complications – myocardial infarction and ischemic stroke. The issues of surgical strategy in such patients have not yet been finally resolved. The situation is complicated in cases when along with carotid-coronary lesions there exist significant obstructions in other arterial regions – renal, visceral arteries, aorto-iliac and femoral-popliteal segments of the arterial bed. This paper describes a clinical case of combined lesions of all five main arterial territories in a patient with recently diagnosed oncological disease. We present the strategy and results of the first stage of surgical treatment: simultaneous reconstruction of the carotid, coronary and renal arteries.


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About Authors

Mikhail D. Alshibaya, Dr. Med. Sci., Professor, Head of Department; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery