Are there alternatives to dual antiplatelet therapy after stenting of peripheral arteries?

Bredikhin R.A.^1,2, Krepkogorsky N.V.^1,2, Khairullin R.N.¹

¹ Department of Vascular Surgery, Interregional Clinical and Diagnostic Centre,
² Department of Cardiovascular and Endovascular Surgery, Kazan State Medical University, Kazan, Russia

It is estimated that more than 200 million people worldwide suffer peripheral artery disease and the rate of amputations remains at a high level. The basis of treatment is timely revascularization wherein the fraction of interventions performed endovascularly has steadily been growing both in Russia and abroad. Nevertheless, the parameters of long-term patency of endovascular reconstructions of the infrainguinal segment are still inferior to open interventions. In order to select an optimal method of revascularization and to predict the duration of patency of the reconstruction modern clinical guidelines suggest using the GLASS and WIfI scales, which may improve the remote results of the intervention. Moreover, modern paclitaxel-coated stents and balloons may help increase primary patency of the reconstruction after endovascular procedures. A not less important method of improving remote results of endovascular treatment of patients with peripheral artery disease is considered to be the use of contemporary regimens of antithrombotic therapy. The VOYAGER PAD trial showed that in patients with peripheral artery disease after endured revascularization of lower limbs rivaroxaban prescribed at a dose of 2.5 mg twice daily in a combination with conventional antithrombocytic therapy made it possible to decrease the risk of such ischaemic complications as acute limb ischaemia, major amputation, myocardial infarction, ischaemic stroke and death of cardiovascular causes.

KEY WORDS: peripheral artery disease, revascularization, antithrombotic therapy, WIfI, GLASS, stenting, balloon angioplasty.

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