Aortic & peripheral vascular disease
Antithrombotic therapy following revascularization for chronic limb-threatening ischaemia: a European survey from the ESC Working Group on Aorta and Peripheral Vascular Diseases
Authors' conclusion
Current antithrombotic therapy of CLTI patients undergoing LER remains largely discretional, and prescription of DPI is related to reimbursement policies. An individualised assessment of thrombotic and bleeding risks is largely missing.
Study context
- Population
- Physicians managing antithrombotic therapy after lower extremity revascularization (LER) for chronic limb-threatening ischaemia (CLTI)
- Participants
- 225 respondents
- Outcome
- Antithrombotic therapy after LER for CLTI
Methodological detailsinternet-based survey, European, ESC Working Group on Aorta and Peripheral Vascular Diseases, with other European scientific societies
- Internet-based survey
- European
- ESC Working Group on Aorta and Peripheral Vascular Diseases, with other European scientific societies
Main finding
As reported in the abstract
- Dedicated protocols reported
- 36%
- DAPT (aspirin + clopidogrel) preferred after surgical LER
- 37%
- DAPT (aspirin + clopidogrel) preferred after endovascular LER
- 79%
- Dual pathway inhibition (DPI) (aspirin + low-dose rivaroxaban) prescribed
- 16%
- DPI prescription associated with availability of reimbursement
- OR 6.88; 95% CI 2.60-18.25
- DPI prescription associated with choice by clinicians rather than physicians performing revascularization
- OR 2.69; 95% CI 1.10-6.58
- ≥6-month intense (two-drug) regimen more common among surgeons than medical specialists
- OR 2.08; 95% CI 1.10-3.94
Observational data: associations, not effects.
Original publication
Antithrombotic therapy following revascularization for chronic limb-threatening ischaemia: a European survey from the ESC Working Group on Aorta and Peripheral Vascular Diseases. Eur Heart J Cardiovasc Pharmacother. Published 8 October 2022. doi:10.
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