| Autor: |
Meuli L; Department of Vascular Surgery, University Hospital Zürich, University of Zürich, 8091 Zürich, Switzerland., Stadlbauer T; Department of Vascular Surgery, University Hospital Zürich, University of Zürich, 8091 Zürich, Switzerland., Stähli BE; Department of Cardiology, University Heart Centre, University Hospital Zürich, University of Zürich, 8091 Zürich, Switzerland., Espinola-Klein C; Centre for Cardiology, Cardiology III-Angiology, University Medical Centre of the Johannes Gutenberg University of Mainz, 55131 Mainz, Germany., Zimmermann A; Department of Vascular Surgery, University Hospital Zürich, University of Zürich, 8091 Zürich, Switzerland., On Behalf Of The Patent Study Collaborators |
| Abstrakt: |
(1) Background: High-level evidence on antithrombotic therapy after infrainguinal arterial bypass surgery in specific clinical scenarios is lacking. (2) Methods: A modified Delphi procedure was used to develop consensus statements. Experts voted on antithrombotic treatment regimens for three types of infrainguinal arterial bypass procedures: above-the-knee popliteal artery; below-the-knee popliteal artery; and distal, using vein, prosthetic, or biological grafts. The treatment regimens for these nine procedures were then voted on in three clinical scenarios: isolated PAOD, atrial fibrillation, and recent coronary intervention. (3) Results: The survey was conducted with 28 experts from 15 European countries, resulting in consensus statements on 25/27 scenarios. Experts recommended single antiplatelet therapy after above-the-knee popliteal artery bypasses regardless of the graft material used. For below-the-knee popliteal artery bypasses, experts suggested combining single antiplatelet therapy with low-dose rivaroxaban if the graft material used was autologous or biological. They did not recommend switching to triple therapy for patients on oral anticoagulants for atrial fibrillation or dual antiplatelet therapy in any scenario. (4) Conclusions: Great inconsistency in the antithrombotic therapy administered was found in this study. This consensus offers guidance for scenarios that are not covered in the current ESVS guidelines but must be interpreted within its limitations. |
