Should Coronary Angiography Be Routine Before Vascular Surgery?

Findings from a small randomized trial show long-term benefits.

Coronary artery revascularization before vascular surgery did not improve outcomes in two previous randomized trials (JW Cardiol Feb 4 2005 and May 23 2007). However, because high complication rates are observed in high-risk patients, controversy surrounds current recommendations to use coronary angiography only after positive findings on noninvasive testing. In the current study, investigators randomized 208 medium-to-high-risk patients to receive coronary angiography either systematically or selectively (i.e., based on positive stress test findings) before undergoing major abdominal vascular surgery.

Coronary artery disease was diagnosed more frequently in the systematic group (62%) than in the selective group (45%), resulting in higher ra…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI