ANTITHROMBOTICS UTILIZATION IN PERIPHERAL ARTERIAL-DISEASE

Antithrombotic agents are frequently used in patients with peripheral arterial occlusive disease. This use is based on controlled clinical t rials but also (mainly) on empirical experience of clinicians or on ex trapolation from data obtained in coronary patients. The present paper reviews briefly the indications of anti-platelet and anticoagulant tr eatments in the settings of primary prevention, and secondary preventi on in chronic or acute arterial insufficiency of lower limbs, after re vascularization surgery, and following angioplastic procedures. Many r ecommendations are derived from corresponding situations in the corona ry setting although analogies are not always pertinent. In summary, as pirin is indicated in almost all patients with peripheral arterial occ lusive disease, at least for preventing acute coronary or cerebrovascu lar events. Heparin is used (or even indicated) during vascular surgic al or interventional radiologic procedures. The place of oral anticoag ulants is less well established, except after an acute arterial obstru ction from an embolus of cardiac origin. Nonetheless, they are frequen tly prescribed after distal bypasses (below the knee) or in case of po or run-off.