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[Antithrombotic therapy and follow-up of peripheral arterial occlusive disease]

H K Breddin1

  • 1Universitätsklinikum Frankfurt am Main.

In patients with arterial occlusive disease the following antithrombotic drugs are used to prevent new arterial thromboses: Unfractionated heparin (UFH) and low molecular weight heparins (LMWH): UFH is frequently used perioperatively in patients with vascular reconstructions and after peripheral percutaneous transluminal angioplasty (PTA). Only one study on the longterm use of a LMWH after operative revascularization has been published, where LMWH led to an increased patency rate in comparison to acetylsalicylic acid + dipyridamol. Vitamin-K-antagonists were effective in the prevention of new vascular occlusions in studies published in the 1970ies. Platelet function inhibitors (aspirine, ticlopidine and clopidogrel): Aspirine reduced reocclusions after vascular surgery and PTA. Ticlopidine was effective in the Swedish Ticlopidine-Multicenter-Trial in the prevention of ischemic heart disease and also reduced the need for vascular surgery. In the CAPRIE-study clopidogrel reduced myocardial infarctions in patients with peripheral arterial disease in comparison to aspirine.

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