[Anticoagulation after arterial reconstruction in peripheral arterial occlusive disease (observations over more than...

1051 extremities with arterial reconstruction and anticoagulant prophylaxis were followed for at least 15 to 25 years. The results as to patency rate were best in patients with anticoagulation permanently in the therapeutic range. Interruption of the prophylaxis led to occlusions in half of the patients, most within the first year. 42 bleeding complications occurred in 37 patients, 0.005 per treatment year, 0.002 gastrointestinal, 0.0004 cerebral, 0.0001 with fatal outcome. Most bleedings occurred within the first ten years, 0.6 per treatment year in the first, 0.38 between the third and the seventh year, reaching a steady level of 0.46 at twelve years. Prophylaxis after arterial reconstruction for peripheral arterial disease should be restricted to patients without contraindications, in whom an optimal anticoagulation can be achieved within the first year.