scholarly journals Incidence of Venous Thromboembolism in Patients With Peripheral Arterial Disease After Endovascular Intervention

2022 ◽  
Vol 75 (1) ◽  
pp. e29-e30
Author(s):  
Daniel G. Kindell ◽  
Emilie G. Duchesneau ◽  
Sydney E. Browder ◽  
Deanna Caruso ◽  
Nathan T. Shenkute ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Endovascular Intervention ◽  
Peripheral Arterial

scholarly journals P6: ANTIPLATELET AND ANTICOAGULANT USE IN RANDOMISED TRIALS OF PATIENTS UNDERGOING ENDOVASCULAR INTERVENTION FOR PERIPHERAL ARTERIAL DISEASE: SYSTEMATIC REVIEW

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
MI Qureshi ◽  
HL Li ◽  
GK Ambler ◽  
KHF Wong ◽  
S Dawson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peripheral Arterial Disease ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Arterial Intervention ◽  
Arterial Disease ◽  
Endovascular Intervention ◽  
Randomised Trials ◽  
Peripheral Arterial ◽  
High Level

Abstract Introduction Guideline recommendations for antithrombotic (antiplatelet and anticoagulant) therapy during and after endovascular intervention are patchy and conflicted, in part due to a lack of evidence. The aim of this systematic review was to examine the antithrombotic specifications in randomised trials for peripheral arterial endovascular intervention. Method This review was conducted according to PRISMA guidelines. Randomised trials including participants with peripheral arterial disease undergoing endovascular arterial intervention were included. Trial methods were assessed to determine whether an antithrombotic protocol had been specified, its completeness, and the agent(s) prescribed. Antithrombotic protocols were classed as periprocedural (preceding/during intervention), immediate postprocedural (up to 14 days following intervention) and maintenance postprocedural (therapy continuing beyond 14 days). Trials were stratified according to type of intervention. Result Ninety-four trials were included. Only 29% of trials had complete periprocedural antithrombotic protocols, and 34% had complete post-procedural protocols. In total, 64 different periprocedural protocols, and 51 separate postprocedural protocols were specified. Antiplatelet monotherapy and unfractionated heparin were the most common choices of regimen in the periprocedural setting, and dual antiplatelet therapy (55%) was most commonly utilised postprocedure. There is an increasing tendency to use dual antiplatelet therapy with time or for drug-coated technologies. Conclusion Randomised trials comparing different types of peripheral endovascular arterial intervention have a high level of heterogeneity in their antithrombotic regimens, and there has been an increasing tendency to use dual antiplatelet therapy over time. Antiplatelet regimes need to be standardised in trials comparing endovascular technologies. Take-home message To determine the benefits of any endovascular intervention within a randomised trial, antithrombotic regimens should be standardised to prevent confounding. This systematic review demonstrates a high level of heterogeneity of antithrombotic prescribing in randomised trials of endovascular intervention, and an increasing tendency to utilise dual antiplatelet therapy, despite a lack of evidence of benefit, but an increased risk of harm.

scholarly journals Statin Therapy Is Associated With Improved Clinical Outcomes in Patients With Symptomatic Peripheral Arterial Disease Undergoing Endovascular Intervention

2012 ◽  
Vol 55 (2) ◽  
pp. 625
Author(s):  
Francesco A. Aiello ◽  
Gisberto Evangelisti ◽  
Andrew J. Meltzer ◽  
Ashley Graham ◽  
James F. McKinsey ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Statin Therapy ◽  
Clinical Outcomes ◽  
Arterial Disease ◽  
Endovascular Intervention ◽  
Peripheral Arterial

scholarly journals COVID Toes: Concurrent Lower Limb Arterial and Venous Thromboembolism in a Patient with COVID-19 Pneumonitis Presenting with Foot Ischaemia

2021 ◽  
pp. 153857442110456
Author(s):  
Kathryn A. Lee ◽  
Richard S. McBride ◽  
Ranjeet Narlawar ◽  
Rebecca Myers ◽  
George A. Antoniou
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Venous Thromboembolism ◽  
Peripheral Arterial Disease ◽  
Lower Limb ◽  
Respiratory Symptoms ◽  
Arterial Disease ◽  
High Index ◽  
Peripheral Arterial ◽  
High Index Of Suspicion

We present a 74-year-old gentleman, who presented with foot ischaemia requiring bilateral amputation in the absence of radiological signs of occlusive peripheral arterial disease. He was found to have COVID-19 pneumonitis and concurrent arterial and venous thromboemboli despite no initial respiratory symptoms or signs, nor pre-existing risk factors for cardiovascular disease. Patients who present with foot ischaemia with or without respiratory symptoms or signs warrant a high index of suspicion for COVID-19 infection, particularly in those with no predisposing risk factors.

The adverse effects of androgen-deprivation therapy: Comparison between gonadotropin-releasing hormone agonists and orchiectomy in the SEER-Medicare population.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 304-304
Author(s):  
Maxine Sun ◽  
Ole-Petter Riksfjord Hamnvik ◽  
Guillermo de Velasco ◽  
Wei Jiang ◽  
Stacy Loeb ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Venous Thromboembolism ◽  
Adverse Effects ◽  
Peripheral Arterial Disease ◽  
Androgen Deprivation Therapy ◽  
Cognitive Disorders ◽  
Arterial Disease ◽  
Gonadotropin Releasing Hormone ◽  
Bilateral Orchiectomy ◽  
Peripheral Arterial

304 Background: Androgen-deprivation therapy (ADT) through surgical castration is equally effective as medical castration in controlling prostate cancer (PCa). However, the adverse effect profiles of both ADT groups have never been compared. Our objective was to provide a comparative effectiveness analysis of the adverse effects of gonadotropin-releasing hormone agonists (GnRHa) vs. bilateral orchiectomy in a homogeneous population. Methods: A total of 3295 men with metastatic PCa aged ≥ 66 years old, treated with GnRHa or bilateral orchiectomy between 1995 and 2009 were identified. Multivariable competing-risks regression models were performed, with the adjustment of all-cause mortality and treatment propensity score. Secondary analyses examined the effect of increasing duration of GnRHa treatment, and expenditures. Our main examined measures were: [1] any fractures, [2] peripheral arterial disease, [3] venous thromboembolism, [4] cardiac-related complications, [5] diabetes mellitus, [6] cognitive disorders, and [7] total expenditures. Results: In adjusted analyses, orchiectomy was associated with significantly lower risks of any fracture (HR: 0.80, 95% CI: 0.65–0.97), peripheral arterial disease (HR: 0.70, 95% CI: 0.53–0.92), and cardiac-related complications (HR: 0.82, 95% CI: 0.69–0.97) compared to those treated with GnRHa. No statistically significant difference was noted between orchiectomy and GnRHa for diabetes and cognitive disorders. When compared to individuals treated for ≥ 35 months with GnRHa, the increased risk for GnRHa compared to orchiectomy was noted for fractures, peripheral arterial disease, venous thromboembolism, cardiac-related complications, and diabetes mellitus (HR: 1.69, 2.19, 1.60, 1.62, and 1.36, respectively, all P≤ 0.04). No difference with respect to total expenditures was observed between GnRHa and orchiectomy (odds ratio [OR]: 1.21, 95% CI: 0.92–1.58). Conclusions: GnRHa was associated with higher risks in 3/7 examined adverse effects: any fractures, peripheral arterial disease rates, and cardiac-related complications.

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