a combined approach to severe multi-organ atherosclerosis

severe coronary artery disease often coexists with peripheral vascular atherosclerosis. the assessment of the supra-aortic circulation is, therefore, of clinical relevance. we herein describe a case of coronary artery disease treated with surgical revascularization using the internal mammary artery and thereafter the progressive atherosclerotic disease of the native coronary arteries as well as the left subclavian and left renal arteries. we also describe and discuss the clinical presentation, the diagnostic procedures, and the therapeutic approach with respect to the percutaneous transluminal angioplasty of the subclavian, renal, and right coronary arteries.