Antithrombotic Therapy in Peripheral Artery Disease: Stepping in the Right Direction

AbstractWe reviewed the various antithrombotic therapies available to treat peripheral artery disease (PAD). A literature review using the PubMed and MEDLINE databases used the following keywords: antithrombotic therapy, anticoagulation, peripheral artery disease, and peripheral vascular disease. Randomized studies written in English that assessed the use of antithrombotic therapy in patients with PAD were evaluated. PAD is a worldwide condition that limits blood flow in the lower extremities, leading to a risk of major adverse cardiovascular events and major adverse limb events. Antithrombotic therapy is necessary to prevent these complications, and the choice of therapy depends upon the stage of disease progression. For symptomatic patients in the beginning stage, single antiplatelet therapy (SAPT) is the preferred therapy, specifically, aspirin. For patients undergoing endovascular revascularization, the preferred therapy is dual antiplatelet therapy using aspirin and clopidogrel combined for at least the first month followed by long-term SAPT. For patients undergoing surgical revascularization, the preferred choice of therapy depends upon the type of graft used, with better results obtained with antiplatelet therapy for prosthetic grafts and anticoagulation for venous grafts. New studies have shown that therapy using both antiplatelets and anticoagulation in the form of aspirin plus low-dose rivaroxaban can reduce complications in all three patient populations, which has ...
Source: American Journal of Cardiovascular Drugs - Category: Cardiology Source Type: research

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In this study, we investigated incidence, diagnosis and treatment of PAES in current vascular practice. A retrospective analysis of all patients with PAES visiting 31 participating institutes between 2003 and 2015 was conducted. Thirty-five limbs (28 patients) were identified during the 13-year study period, and the incidence of PAES was 0.12% of all peripheral artery disease cases revascularized.  Mean age was 32.0 ± 16.9 years old, and 60 and more years old was 10.7%. Also, 92.9% were male and 39.3% were athletes. Most frequent initial symptoms were intermittent claudication in 23 limbs (65...
Source: Cardiovascular Intervention and Therapeutics - Category: Cardiology Source Type: research
Conditions:   Coronary Disease;   Peripheral Arterial Disease;   Collateral Circulation, Any Site Intervention:   Diagnostic Test: Blood samples Sponsor:   Jung-min Ahn Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Ann Cardiol Angeiol (Paris). 2021 Sep 10:S0003-3928(21)00088-3. doi: 10.1016/j.ancard.2021.07.005. Online ahead of print.ABSTRACTSTUDY'S GOAL: As there are no guidelines. This short report shows our experience in management of sub-acute limb ischemia with polyarteritisnodosa.INTRODUCTION: Acute limb ischemia is rarely seen in periarteritisnodosa.CASE REPORT: Here, we present a case with peripheral vascular disease of both lower limbs leading to foot claudication and then a subacute limb ischemia with large necrotic plaques on the lower limb. Angioscan showed occlusion of both superficial femoral arteries. Angiographic imag...
Source: Annales de Cardiologie et d'Angeiologie - Category: Cardiology Authors: Source Type: research
ACS Applied Materials&InterfacesDOI: 10.1021/acsami.1c11349
Source: ACS Applied Materials and Interfaces - Category: Materials Science Authors: Source Type: research
The relationship between retrograde arterial perfusion and stroke in patients with peripheral vascular disease has been widely documented. Antegrade arterial perfusion has been favoured as an alternative approach in less invasive mitral valve (MV) operations. We aimed to analyse our experience in patients with peripheral arterial disease undergoing MV surgery through a right mini-thoracotomy adopting antegrade arterial perfusion.
Source: Heart, Lung and Circulation - Category: Cardiology Authors: Tags: Original Article Source Type: research
CONCLUSION: The present meta-analysis suggests that pro-angiogenic modulation of microRNAs accelerates vascular perfusion recovery in animal models of acute hind limb ischemia. Further studies on animal models with similar characteristics to that of PAD patients are warranted to translate those findings in human PAD setting.PMID:34509635 | DOI:10.1016/j.vph.2021.106906
Source: Vascular Pharmacology - Category: Drugs & Pharmacology Authors: Source Type: research
CONCLUSIONS: Findings demonstrate that phase II CR is highly effective in the control of BP, although improvements are not equally distributed to all individuals according to differences in sex, race/ethnicity, and access to insurance-funded health care.PMID:34508034 | DOI:10.1097/HCR.0000000000000638
Source: Journal of Cardiopulmonary Rehabilitation and Prevention - Category: Rehabilitation Authors: Source Type: research
AbstractIn patients with peripheral artery disease (PAD), supervised exercise at near-moderate pain improves walking ability but not ankle-brachial index (ABI) values. In a retrospective observational study, we determined vascular and functional effects of a 6-month structured pain-free exercise program in patients with claudication and compressible vessels. Four-hundred and fifty-nine consecutive patients were studied. Segmental limb pressures were measured and ABI calculated during circa-monthly hospital visits. The 6-min (6MWD) and the pain-free walking distance (PFWD) during the 6-min walking test were determined. Two ...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research
AbstractPeripheral artery disease (PAD) is highly prevalent, affecting up to 20% of people over 70  years of age. To test the hypothesis that PAD promotes the pathogenesis of vascular cognitive impairment (VCI), we compared cognitive function in older adults with symptomatic PAD and in participants without PAD who had a burden of comorbid conditions. Furthermore, we compared the cognitive functi on of these groups after adjusting for demographic and clinical characteristics, comorbid conditions, and cardiovascular risk factors. Participants with PAD (age: 69 ± 8 years;n = 58) an...
Source: AGE - Category: Geriatrics Source Type: research
Am J Physiol Regul Integr Comp Physiol. 2021 Sep 8. doi: 10.1152/ajpregu.00165.2021. Online ahead of print.ABSTRACTThe mechanoreflex is exaggerated in patients with peripheral artery disease (PAD) and in a rat model of simulated PAD in which a femoral artery is chronically (~72hrs) ligated. We found recently that, in rats with a ligated femoral artery, blockade of thromboxane A2 (TxA2) receptors on the sensory endings of thin fiber muscle afferents reduced the pressor response to 1 Hz repetitive/dynamic hindlimb skeletal muscle stretch (a model of mechanoreflex activation isolated from contraction-induced metabolite produc...
Source: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology - Category: Physiology Authors: Source Type: research
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