Q: My father has a three vessel coronary artery disease along with right superficial femoral artery stenosis with bilateral infra popliteal disease. Doctors are wondering how to treat this in an optimal manner. Please advise?

A:Patients with coronary artery disease may have occlusive disease of other arteries such as carotid, femoral etc. Which should be treated by operation first is decided by the nature and gravity of the coronary artery disease and whether the other arterial disease might create a crisis or complication during the coronary artery procedure. As femoro – popliteal disease seldom produces occlusive crises during coronary artery procedures, your father should have the coronary artery problem attended to (if that is what the doctor has recommended first). The femoro-popliteal disease can be managed medically, by balloon angioplasty or, at times, by vascular reconstruction later.