Angiographic correlates of cardiac death and myocardial infarction complicating major nonthoracic vascular surgery

In an era when many patients with high-grade coronary stenoses undergo revascularization before peripheral vascular surgery, most perioperative infarcts appear to occur due to inadequate collaterization of total occlusions, and a lesser number also occur without any apparent “significant” occlusion. As a consequence, collateralized total occlusions involving substantial areas of viable myocardium may best be considered for revascularization before a major operation of this type.