D D Do1, F Mahler. 1. Department of Medicine, University Hospital, Bern, Switzerland.
Abstract
PURPOSE: To investigate whether anticoagulation or platelet inhibition treatment provides better prevention of reobstruction after percutaneous transluminal angioplasty (PTA). MATERIALS AND METHODS: In a controlled study, 160 patients received eitheroral anticoagulants or a combination of low-dose acetylsalicylic acid (25 mg) and dipyridamole (200 mg) (ASAD) twice daily for 1 year after successful femoropopliteal PTA. Compliance was comparable. The patients in the two groups had similar clinical and angiographic characteristics. Patency was assessed with noninvasive methods 1 day and then 3, 6, and 12 months after PTA and was confirmed at angiography at the end of the study in 112 patients. RESULTS:Patency in patients who received anticoagulants was 53% and was not statistically significantly different from 69% in patients who received ASAD (P = .18). With anticoagulants, there were four bleeding complications (one was fatal); with ASAD, only five minor complications occurred. CONCLUSION: ASAD is at least as effective as anticoagulants for secondary prevention of obstruction after PTA but has less severe side effects.
RCT Entities:
PURPOSE: To investigate whether anticoagulation or platelet inhibition treatment provides better prevention of reobstruction after percutaneous transluminal angioplasty (PTA). MATERIALS AND METHODS: In a controlled study, 160 patients received either oral anticoagulants or a combination of low-dose acetylsalicylic acid (25 mg) and dipyridamole (200 mg) (ASAD) twice daily for 1 year after successful femoropopliteal PTA. Compliance was comparable. The patients in the two groups had similar clinical and angiographic characteristics. Patency was assessed with noninvasive methods 1 day and then 3, 6, and 12 months after PTA and was confirmed at angiography at the end of the study in 112 patients. RESULTS: Patency in patients who received anticoagulants was 53% and was not statistically significantly different from 69% in patients who received ASAD (P = .18). With anticoagulants, there were four bleeding complications (one was fatal); with ASAD, only five minor complications occurred. CONCLUSION:ASAD is at least as effective as anticoagulants for secondary prevention of obstruction after PTA but has less severe side effects.
Authors: Pablo Alonso-Coello; Sergi Bellmunt; Catherine McGorrian; Sonia S Anand; Randolph Guzman; Michael H Criqui; Elie A Akl; Per Olav Vandvik; Maarten G Lansberg; Gordon H Guyatt; Frederick A Spencer Journal: Chest Date: 2012-02 Impact factor: 9.410