Antithrombotic agents after peripheral transluminal angioplasty: a review of the studies, methods and evidence for their use

Objective: to review published studies and assess the strength of the evide nce for the use of antithrombotic agents for the prevention of re-occlusion after peripheral angioplasty. Methods: a literature search was performed. All randomised comparative stud ies with patency assessments ou clinical endpoints were included. The metho ds and results of the studies were compared and evaluated. Results: eleven randomised trials were identified, six of them were double blind. The majority of patients included were those with femoropopliteal le sions. A significant benefit of aspirin in one placebo-controlled study is balanced by no apparent benefit in another study. No dose-dependent effect of aspirin in the range 50-1000 mg/day has been shown in any of the four st udies investigating such an effect. None of the three studies comparing pla telet inhibitors and oral anticoagulants have shown any differences in outc ome and no other well-designed studies of anticoagulants have been reported . Conclusions: evidence for a reduction in the likelihood of re-occlusion or restenosis after peripheral transluminal angioplasty with platelet inhibito rs remains equivocal. Evidence for the efficacy of any other agent in this indication is also lacking.