[Medicinal therapy for interventional surgery of the peripheral vascular system].
The aim of medicinal treatment, during and after femoral and crural interventions is to prevent early or late onset arterial thrombosis of the treated vascular segments. Therefore, unfractionated heparin is administered during the intervention by an intra-arterial or intravenous approach. To avoid late onset thrombosis, administration of platelet function inhibitors is recommended. However, valid data are only available for acetylsalicylic acid (ASA). Therefore, ASA is recommended for long term medication. In several cardiological studies on stent implantation in coronary vessels the combination of ASA and clopidogrel for dual platelet inhibition has been proven to be effective. These results have been transferred to antithrombotic therapy of the lower extremities despite the lack of dedicated studies. There is no evidence for the use of vitamin K antagonists after peripheral interventions.
Tacke
J
J
Institut für Diagnostische und Interventionelle Radiologie/Neuroradiologie, Klinikum Passau, Innstr. 76, 94032 Passau, Deutschland. Josef.Tacke@klinikum-passau.de
Lindhoff-Last
E
E
D000284:Administration, Oral; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001157:Arterial Occlusive Diseases / Q000188:drug therapy*; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use*; D000077144:Clopidogrel; D004359:Drug Therapy, Combination; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D007511:Ischemia / Q000188:drug therapy*; D007866:Leg / Q000098:blood supply*; D008134:Long-Term Care; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention; D013921:Thrombocytopenia / Q000139:chemically induced; D013927:Thrombosis / Q000517:prevention & control*; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D014812:Vitamin K / Q000037:antagonists & inhibitors
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014812:Vitamin K; D006493:Heparin; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin