A clinical approach to the management of the patient with coronary (Co) and/or carotid (Ca) artery disease who presents with leg ischaemia (Lis)

The purpose of this document is to provide the clinician with easy-to-use g uidelines when faced with a patient with severe ischaemia in the limbs requ iring interventional treatment; the CoCaLis document does not focus on the management of the lower limb ischaemia, but rather on the best possible app roach to the associated coronary and/or carotid artery disease. The first p art of the text deals with the epidemiological aspects of this condition fo llowed by a description of, and proposals for, the management of risk facto rs. The next part deals with the approach to the coronary circulation and t he carotid territory. In each part attention is mainly given to the practic al aspects in terms of both diagnosis and treatment; for each of these step s the costs involved are considered and attention given to balancing the cl inical decisions against the costs. The recommendations given are 'evidence based' when such evidence exists and, if not, the proposals are based on t he consensus of the members of the group. In many instances it was apparent that the necessary information is not available in the literature. The aut hors hope that the CoCaLis document may not only improve the management of the vascular patient but also stimulate further research in this difficult clinical condition which carries a significantly increased risk for the pat ient.