Coronary artery surgery may be envisaged in the context of diffuse arterial disease, especially in association with lesions of the cerebral and lower limb axes. The object of this paper is to advance the concept of coronary surgery coupled with peripheral vascular surgery. Ten patients underwent double revascularisation (coronary and peripheral vessels) between 1977 and 1979. In Group I (5 patients) coronary surgery was coupled with simultaneous cerebral revascularisation (1 aorto-brachiocephalic bypass and 4 endarterectomies). Group II comprised 5 patients undergoing simultaneous coronary and aorto-bifemoral bypass surgery. No operative deaths or serious complications were observed in this short series. The practical conclusions are in favour of widening the indications for simultaneous coronary and cerebral revascularisation. However, the indications for coronary surgery coupled with lower limb revascularisation must be precise and, therefore, more limited.