Antiplatelet therapy in peripheral arterial disease
DOI: 10.32364/2587-6821-2020-4-2-89-94
M.R. Kuznetsov1,2, V.Yu. Bogachev1, S.V. Sapelkin3, I.V. Kosykh1, E.E. Fedorov2, A.A. Atayan4
1Pirogov Russian National Research Medical University , Moscow, Russian Federation
2N.E. Bauman City Clinical Hospital No. 29, Moscow, Russian Federation
3A.V. Vishnevsky National Medical Research Center of Surgery, Moscow, Russian Federation
4Sechenov University, Moscow, Russian Federation
In recent years, peripheral arterial disease (PAD) has emerged as a global health concern due to its high prevalence. This paper addresses current issues in the treatment of PAD which is a manifestation of systemic atherosclerosis. The development of thrombotic complications affecting both major and peripheral arteries is described in detail. Antiplatelet therapy is particularly important to prevent vascular events. There are two major groups of antiplatelets, i.e., acetylsalicylic acid (ASA) and ADP receptor antagonists. The importance of long-term (and even lifetime) antiplatelet treatment is demonstrated. According to the international and Russian guidelines, ASA is a basic antiaggregant medication. Complications of long-term ASA use (i.e., gastropathy) are discussed. ASA enteric-coated tablets are safer as compared with other formulations. According to the international and Russian guidelines, this is ASA that is a basic medication for long-term or lifetime antiplatelet tr eatment (level of evidence 1A). Meanwhile, dual antiplatelet therapy is prescribed in exceptional cases only, i.e., after endovascular stent dilatation of tibial arteries but only for a month.
Keywords: atherosclerosis obliterans, peripheral arterial disease, chronic limb ischemia, antiplatelet therapy, acetylsalicylic acid, Thrombo ASS.
For citation: Kuznetsov M.R., Bogachev V.Yu., Sapelkin S.V. et al. Antiplatelet therapy in peripheral arterial disease. Russian Medical Review. 2020;4(2):89–94. DOI: 10.32364/2587-6821-2020-4-2-89-94.
About the authors:
1,2Maksim R. Kuznetsov — MD, PhD, professor of the Department of Faculty Surgery No. 1 of the Medical Faculty, Head of the Vascular Center, ORCID iD 0000-0001-6926-6809;
1Vadim Yu. Bogachev — MD, PhD, professor of the Department of Faculty Surgery No. 2, ORCID iD 0000-0002-3940-0787;
3Sergey V. Sapelkin — MD, PhD, senior researcher of the Department of Vascular Surgery, ORCID iD 0000-0003-3610-8382;
1Ivan V. Kosykh — MD, PhD, assistant of the Department of Faculty Surgery No. 2, ORCID iD 0000-0002-6707-1562;
2Evgeniy E. Fedorov — MD, PhD, vascular surgeon of the Department of Surgery, ORCID iD ORCID 0000-0001-8140-6923;
4Andrey A. Atayan — MD, PhD, associate professor of the Department of Faculty Surgery on the Institute of Clinical Medicine, ORCID iD 0000-0001-8914-7735.
1Pirogov Russian National Research Medical University. 1, Ostrovityanov str., Moscow, 117437, Russian Federation
2N.E. Bauman City Clinical Hospital No. 29. 2, Hospital square, Moscow, Russian Federation.
3A.V. Vishnevsky National Medical Research Center of Surgery. 27, Bol’shaya Serpukhovskaya str., Moscow, 111020, Russian Federation.
4Sechenov University. 8 Build. 2, Trubetskaya str., Moscow, 119991, Russian Federation.
Contact information: Maksim R. Kuznetsov, e-mail: mrkuznetsov@mail.ru. Financial Disclosure: no authors have a financial or property interest in any material or method mentioned. There is no conflict of interests. Received 17.03.2020.
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