[Anticoagulation and antiaggregation in patients with peripheral arterial occlusive diseases].
Peripheral vascular occlusive disease (PAOD) is frequently seen in patients suffering from coronary heart or cerebrovascular disease and is, considered as a prognostic predictor for the morbidity and mortality of this patient group. Thus, secondary antithrombotic and antiplatelet prophylaxis in these patients is not limited to achievement of long-term patency of the revascularized or recanalized arterial segment, but plays as well a pivotal role for the prevention of myocardial infarction and stroke. Generally, claudicants as well as patients undergoing percutaneous transluminal angioplasty (PTA), supragenicular femoro-popliteal artificial bypass surgery, aortofemoral, iliaco-femoral unilateral bypass, or aortobifemoral Y-graft implantation with unimpaired arterial outflow are treated life-long with low dose acetylsalicylic acid (ASA) 75-250 mg. On the other hand, those undergoing axillo-femoral, femoro-femoral crossover, aorto-profundal or femoro-popliteal infragenicular and femoro-distal venous bypass surgery should be treated with vitamin K antagonists. The role of Clopidogrel in secondary prevention after peripheral revascularization and recanalization still needs to be defined.
Dörffler-Melly
J
J
Schweizerisches Herz- und Gefässzentrum, Angiologisch-Gefässchirurgische Poliklinik, Inselspital Bern, Bern.
Schmidli
J
J
Mahler
F
F
D000284:Administration, Oral; D000800:Angioplasty, Balloon; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D001157:Arterial Occlusive Diseases / Q000188:drug therapy* / Q000601:surgery; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use*; D001807:Blood Vessel Prosthesis; D000077144:Clopidogrel; D016001:Confidence Intervals; D004176:Dipyridamole / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D017128:Embolectomy; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D016285:Iloprost / Q000008:administration & dosage / Q000627:therapeutic use; D007383:Intermittent Claudication / Q000188:drug therapy; D007866:Leg / Q000098:blood supply; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009203:Myocardial Infarction / Q000517:prevention & control; D016491:Peripheral Vascular Diseases / Q000188:drug therapy* / Q000601:surgery; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D020521:Stroke / Q000517:prevention & control; D017131:Thrombectomy; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D013997:Time Factors; D014812:Vitamin K / Q000037:antagonists & inhibitors
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D010975:Platelet Aggregation Inhibitors; D014812:Vitamin K; D004176:Dipyridamole; D006493:Heparin; D000077144:Clopidogrel; D016285:Iloprost; D013988:Ticlopidine; D001241:Aspirin