The Role for Combined Antithrombotic Therapy With Platelet and Coagulation Inhibition After Lower Extremity Revascularization.

Journal Article (Journal Article;Review)

Evidence for antithrombotic treatment following lower extremity revascularization (LER) for peripheral artery disease (PAD) is limited, leading to weak and conflicting guideline recommendations and heterogeneous practice patterns. This variability in post-LER antithrombotic treatment raises quality-of-care issues that have long been under-studied. This Viewpoint reviews the most updated guidelines, currently-available evidence, and contemporary data about practice patterns and practitioner opinions in this area. Particular attention is paid to distinctions between antiplatelet therapy, anticoagulant therapy, and combination therapy in light of the recent VOYAGER-PAD (Vascular Outcomes Study of ASA [acetylsalicylic acid] Along with Rivaroxaban in Endovascular or Surgical Limb Revascularization for PAD) trial. The implications of VOYAGER-PAD pertaining to various subgroups of patients undergoing LER are explored. Overall, this Viewpoint argues for consideration of post-LER therapy targeted at both platelet function and the coagulation cascade, though further LER-specific analyses, including expected VOYAGER-PAD sub-analyses, are needed.

Full Text

Duke Authors

Cited Authors

  • Weissler, EH; Aboyans, V; Bauersachs, R; Brodmann, M; Nikol, S; Debus, S; Patel, MR; Jones, WS

Published Date

  • April 12, 2021

Published In

Volume / Issue

  • 14 / 7

Start / End Page

  • 796 - 802

PubMed ID

  • 33826501

Electronic International Standard Serial Number (EISSN)

  • 1876-7605

Digital Object Identifier (DOI)

  • 10.1016/j.jcin.2021.01.035


  • eng

Conference Location

  • United States