Should Antiplatelet Therapy Be Withheld Perioperatively? The First Study Examining Outcomes in Patients Receiving Dual Antiplatelet Therapy in the Lower Extremity Free Flap Population

2021 ◽  
Vol 149 (1) ◽  
pp. 95e-103e
Author(s):  
Mark D. Mishu ◽  
Elizabeth G. Zolper ◽  
Paige K. Dekker ◽  
Christopher M. Fleury ◽  
Jenna C. Bekeny ◽  
...  
2019 ◽  
Vol 229 (4) ◽  
pp. e64
Author(s):  
Bala Ramanan ◽  
Haekyung Jeon-Slaughter ◽  
Xiaofei Chen ◽  
Vikram S. Kashyap ◽  
Melissa L. Kirkwood ◽  
...  

Author(s):  
Nathan Belkin ◽  
Jordan B. Stoecker ◽  
Benjamin M. Jackson ◽  
Scott M. Damrauer ◽  
Julia Glaser ◽  
...  

2019 ◽  
Vol 24 (6) ◽  
pp. 528-535 ◽  
Author(s):  
Tanner I Kim ◽  
Julia F Chen ◽  
Kristine C Orion

Antiplatelet therapy is commonly prescribed following endovascular interventions. However, there is limited data regarding the regimen and duration of antiplatelet therapy following lower extremity endovascular interventions. The aim of this study was to investigate the practice patterns of dual antiplatelet therapy (DAPT) after lower extremity endovascular interventions. We identified all patients who received an endovascular intervention in the Vascular Study Group of New England (VSGNE) registry from 2010 through 2018. The antiplatelet regimen was examined at the time of discharge and follow-up. Variables predicting discharge antiplatelet therapy and duration of antiplatelet therapy were investigated. There were 13,510 (57.69%) patients discharged on DAPT, 8618 (36.80%) patients discharged on single antiplatelet therapy, and 1292 (5.51%) patients discharged without antiplatelet therapy. Patients with coronary artery disease (CAD), prior vascular bypass and endovascular intervention, preoperative statin use, stent placement compared with angioplasty, and femoropopliteal and tibial treatment were associated with higher odds of being discharged with DAPT compared with no antiplatelet therapy and single antiplatelet therapy. Of the patients discharged on DAPT who were followed up at 9–12 months and 21–24 months, 56.49% and 49.63% remained on DAPT, respectively. Only a narrow margin of the patient majority undergoing endovascular interventions was discharged with DAPT, suggesting that only a small proportion of patients undergoing endovascular intervention remain on DAPT long-term. As the number of peripheral vascular interventions continues to grow, further studies are crucial to identify the optimal duration of DAPT.


2014 ◽  
Vol 64 (11) ◽  
pp. B149
Author(s):  
Avantika Banerjee ◽  
Karan Sarode ◽  
Atif Mohammad ◽  
Seth Jelinek ◽  
Karthik D. Mekala ◽  
...  

2016 ◽  
Vol 64 (6) ◽  
pp. 1633-1644.e1 ◽  
Author(s):  
Peter A. Soden ◽  
Sara L. Zettervall ◽  
Klaas H.J. Ultee ◽  
Bruce E. Landon ◽  
A. James O'Malley ◽  
...  

Author(s):  
Bala Ramanan ◽  
Haekyung Jeon-Slaughter ◽  
Xiaofei Chen ◽  
Vikram S. Kashyap ◽  
Melissa L. Kirkwood ◽  
...  

2021 ◽  
Author(s):  
Jongkwon Seo ◽  
Byung Gyu Kim ◽  
Gwang Sil Kim ◽  
Moo-Nyun Jin ◽  
Hye Young Lee ◽  
...  

Abstract Background: The duration of antiplatelet therapy after endovascular revascularization in patients with lower-extremity artery disease (LEAD) has not been well-established. This study aimed to investigate the optimal strategy for antiplatelet therapy after successful endovascular revascularization in patients with LEAD. Methods: From April 2009 to June 2019, 376 patients with LEAD underwent successful endovascular revascularization. After the procedure, the patients received mono-antiplatelet therapy (MAPT) or dual-antiplatelet therapy (DAPT) of various durations and were classified into 2 groups (MAPT or DAPT < 6 months vs. DAPT ≥ 6 months). The primary outcomes were major adverse cardiovascular events (MACE) and major adverse limb events (MALE). The safety outcome was moderate-to-severe bleeding according to the Global Use of Strategies to Open Occluded Arteries (GUSTO) criteria.Results: Over the 40-month follow-up period, MACE occurred less frequently in the DAPT ≥ 6 months group than the MAPT or DAPT < 6 months group (12.4% vs. 23.8%; hazard ratio: 0.62; 95% confidence interval: 0.40 to 0.97; p = 0.038) after inverse probability-weighted adjustment and propensity-score matching. The incidence of MALE showed no significant intergroup difference (17.1% vs. 13.1%; hazard ratio: 0.94; 95% confidence interval: 0.56 to 1.59; p = 0.822). The incidence of moderate-to-severe GUSTO bleeding also showed no significant intergroup difference (3.5% vs. 4.9%; hazard ratio: 0.59; 95% confidence interval: 0.21 to 1.63; p = 0.308). Conclusions: For patients with LEAD, DAPT for ≥6 months after endovascular revascularization was associated with a lower incidence of MACE without increasing the risk of bleeding events.


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