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THE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


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The Journal of Cardiovascular Surgery 2017 Sep 20

DOI: 10.23736/S0021-9509.17.10210-7

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Anticoagulation and antiplatelet therapy in patients with peripheral arterial disease of the femoro-popliteal arteries

Cornelis G. VOS , Anco VAHL

Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands


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Peripheral arterial disease (PAD) is associated with a substantial cardiovascular risk and secondary prevention is recommended for all patients. In this report the literature on anticoagulant and antiplatelet drugs for patients with PAD in the femoro-popliteal segment is reviewed. PubMED/MEDLINE and Cochrane Database was searched for studies published between January 1966 and August 2017. Meta-analyses and randomized controlled trials describing outcome of anticoagulants or antiplatelet drugs for secondary prevention or following vascular interventions in patients with PAD were included. All patients with PAD should receive antiplatelet therapy to reduce cardiovascular risk with a slight preference for clopidogrel monotherapy. Following intervention most patients will continue to benefit from this treatment. Patients receiving a venous bypass graft will benefit from VKA treatment and those with a below-knee prosthetic bypass graft should receive dual antiplatelet therapy (acetylsalicylic acid combined with clopidogrel). Further sufficiently powered studies are needed to further explore the optimal medical treatment for patients that undergo vascular interventions.


KEY WORDS: Peripheral arterial disease - Anticoagulation - Secondary prevention - Cardiovascular risk management - Potency - Medical treatment

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Publication History

Article first published online: September 20, 2017
Manuscript accepted: September 13, 2017
Manuscript received: September 6, 2017

Cite this article as

G Vos C, Vahl A. Anticoagulation and antiplatelet therapy in patients with peripheral arterial disease of the femoro-popliteal arteries. J Cardiovasc Surg 2017 Sep 20. DOI: 10.23736/S0021-9509.17.10210-7

Corresponding author e-mail

c.g.vos@olvg.nl