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Updated: Dec 5, 2025
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
[Current concepts of anticoagulant and antiplatelet therapy in patients with vascular pathology]
1Vascular Surgery Department, National Medical Research Centre named after A.V. Vishnevsky under the RF Ministry of Public Health, Moscow, Russia.
Insights
Vascular surgeons use antithrombotic therapy to reduce cardiovascular events. Selecting the right anticoagulant, like direct-acting oral factor Xa inhibitors, is crucial for personalized patient care.
Area of Science:
- Cardiovascular Surgery
- Pharmacology
Background:
- Antithrombotic therapy is essential for managing arterial and venous pathologies.
- The array of available antithrombotic agents complicates treatment selection.
- Balancing ischemic and hemorrhagic risks is critical in patient management.
Purpose of the Study:
- To highlight the importance of personalized antithrombotic therapy in vascular surgery.
- To discuss the challenges in selecting appropriate antithrombotic agents.
- To emphasize the role of modern anticoagulants in optimizing patient treatment.
Main Methods:
- Review of current antithrombotic drug classes and their mechanisms.
- Consideration of patient-specific factors (nosology, etiology, comorbidities).
- Evaluation of the risk-benefit profile of different antithrombotic strategies.
Main Results:
- Modern antithrombotic drugs facilitate a more personalized treatment approach.
- Direct-acting oral factor Xa inhibitors offer flexible dosing and regimens.
- Rivaroxaban exemplifies an anticoagulant suitable for tailored therapy in vascular patients.
Conclusions:
- Personalized antithrombotic therapy is paramount in vascular surgery.
- The selection of antithrombotics requires careful consideration of individual patient profiles.
- Direct-acting oral factor Xa inhibitors, such as rivaroxaban, enhance the ability to personalize treatment for arterial and venous pathologies.
Abstract:
The routine practice of a vascular surgeon is invariably associated with decreasing the risk of adverse cardiovascular events in patients presenting with either arterial or venous pathology. Antithrombotic therapy is one of the key approaches used to achieve this purpose. However, a wide variety of modern drugs inhibiting platelet aggregation and agents blocking the coagulation cascade, as well as their combinations makes the selection of the most appropriate treatment for a particular patient quite a difficult task. The choice should carefully be made taking into consideration the nosology, aetiology, accompanying diseases and therapy thereof, as well as the balance of the risk of ischaemic and haemorrhagic complications. Therefore, availability of modern antithrombotic drugs favourably contributing to a more personified approach to treatment is of utmost importance. Thus, for example, rivaroxaban, an anticoagulant belonging to the class of direct-acting oral factor Xa inhibitors, provides a possibility to select an optimal dosage and regimen for a particular patient with arterial or vascular pathology in practice of a cardiovascular surgeon.
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