Methods of decreasing the risk of repeat interventions in patients after arterial revascularization

Kuznetsov M.R.^1,3, Reshetov I.V.¹, Sapelkin S.V.², Yasnopolskaya N.V.³, Karalkin P.A.²

1) Institute of Cluster Oncology named after L.L. Levshin, I.M. Sechenov First Moscow State Medical University under the RF Ministry of Public Health,
2) Department of Vascular Surgery, National Medical Research Centre of Surgery named after A.V. Vishnevsky under the RF Ministry of Public Health,
3) Department of Cardiovascular Surgery №1, City Clinical Hospital named after S.S. Yudin, Moscow, Russia

Discussed in the article are the main problems related to surgical treatment of patients with peripheral artery disease, particularly taking into consideration that in the world there are from 160 to 202 million people suffering from this disease, with two thirds of such patients having signs of lesions of coronary or cerebral arteries. Vascular reconstructive interventions cannot completely eliminate the problem, since in the postoperative period there may develop cardiovascular complications related to both the limb involved as either acute or progressing chronic ischaemia and arteries of other localization (coronary, cerebral).

The risk of serious cardiovascular complications in patients with a history of endured adverse ischaemic events on the part of limbs is severalfold higher. To solve these problems and decrease complications, salicylic acid is used as basic therapy. Attempts at replacing it by another drug or combined therapy with an alternative antiaggregant showed no advantages in increased risk of massive haemorrhage. On the other hand, a combination of salicylic acid with an anticoagulant at a low dose, i. e., rivaroxaban 2.5 mg twice daily as compared with acetylsalicylic acid monotherapy made it possible to significantly decrease the incidence of various cardiovascular complications in the form of myocardial infarction, stroke, adverse ischaemic events on the part of the extremity, limb amputation.

KEY WORDS: peripheral artery disease, atherosclerosis, vascular interventions, GLASS, WIfI, acetylsalicylic acid, rivaroxaban.

P. 175

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