Given the characteristics of ischemic heart disease, this condition is frequently associated with carotid and peripheral artery disease. Cardiac complications of vascular surgery and vascular complications of myocardial revascularization operations are common and severe. However, carotid artery endarterectomy or revascularization procedures for the lower extremities can be combined simultaneously with coronary artery bypass operations with acceptable results. It is difficult to determine whether or not both disorders should be treated surgically in a single stage or in two stages. This decision should be individualized according to the severity of the lesions and the risk of complications if one of these procedures is delayed.