Antithrombotic therapy in patients with lower limb chronic ischemia: is therapy with aspirin alone sufficient?

Abstract

Peripheral artery diseases have increasingly been gaining in medical and social importance due to not only growing morbidity but also therapeutic outcomes not fully satisfying both clinicians and patients, especially those with manifestations of critical limb ischemia. Revascularizing interventions combined with optimal medicamentous treatment are the “gold standard” in treatment of symptomatic lesions of peripheral arteries. Along with it, risks for the development of thrombotic complications both in the zone of the reconstruction and in other vascular basins, negatively influence overall rates of patients’ mortality and disability. Antiplatelet agents have so far remained in fact the only substantiated from the point of view of evidence-based medicine therapeutic factor decreasing the risks for the development of thrombotic complications in this patient cohort. A series of other drugs influencing blood coagulation system, as well as a combination thereof, by the findings of hitherto performed trials failed to demonstrate sufficient efficacy and/or safety. Oral anticoagulants opened new possibilities for antithrombotic prevention and treatment and have widely been used in various cardiovascular diseases. The results of a series of trials the most significant of which may be considered VOYAGER PAD showed possibilities and feasibility of introducing anticoagulants into therapeutic regimens for patients with PAD. Safety and efficacy of treatment regimens envisaging a combination of antiplatelet drugs with rivaroxaban at a dose of 2.5 mg twice daily were demonstrated both for patients undergoing conservative treatment and those after endured endovascular revascularizing interventions.

Keywords:peripheral artery disease; atherosclerosis obliterans; COMPASS; VOYAGER PAD; rivaroxaban; aspirin; revascularization; critical ischemia

Dear readers!

Full-text version of the article is available only in paper version.

  • Российское Общество ангиологов и сосудистых хирургов
  • ВКонтакте
  • Telegram
CHIEF EDITOR
Akchurin Renat Suleymanovich
Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Sciences, Deputy General Director for Surgery, Head of the Department of Cardiovascular Surgery, National Medical Research Center for Cardiology named after Academician E.I. Chazov, President of the Russian Society of Angiologists and Vascular Surgeons

 

In accordance with the decision of the Presidium of the Russian Society of Angiologists and Vascular Surgeons, the journal "Angiology and Vascular Surgery" will be named after Academician A.V. Pokrovsky starting from No. 2/2022.

Вскрытие
Медицина сегодня

Уважаемые коллеги! 10.02.2023 состоится Совместный научно-образовательный симпозиум Национальной Ассоциации по тромбозу и гемостазу и ФГБНУ "Научный центр неврологии" "Тромботические проблемы при цереброваскулярной патологии и коморбидных процессах". Начало регистрации в...

Приглашаем специалистов Сибирского федерального округа 9-10 февраля посетить Школу РОАГ! Успешно продолжается образовательная работа общероссийского проекта "Школы РОАГ". Очередная встреча пройдет 9-10 февраля в онлайн-формате и объединит врачей Иркутска, Кемерово, а также...

Уважаемые коллеги, приглашаем принять участие в конференции "Бронхоэктазы: муковисцидоз и не только-", которая состоится с 3 по 4 февраля в Ижевске! Организаторы: · Общероссийская общественная организация "Российское общество медицинских генетиков" · НМИЦ...


Журналы «ГЭОТАР-Медиа»