The role of antithrombotic therapy on the patency of peripheral bypasses

peripheral bypass surgery is a well-established treatment for symptomatic a therosclerotic disease of the legs. To improve the long-term patency antith rombotic drugs and other adjuvant treatment are applied In this review we s ummarize the results of randomized studies concerning antithrombotic treatm ent for prophylaxis after peripheral bypass surgery Heparin is used routine ly intra- and perioperatively without strong data, and according to few dat a low molecular weight heparin may be superior in this situation. Aspirin h ad positive effects in placebo-controlled studies after infrainguinal PTFE- bypasses, furthermore it is recommended due to its general cardiovascular r isk reduction. Ticlopidine improved long-term patency in one randomized stu dy after venous bypass surgery. Otherwise there are some data that long-ter m oral anticoagulation may be preferable in patients after venous bypass su rgery.