Key result
Clinicians demonstrated a higher preference for dual antiplatelet therapy over monotherapy as the anatomical level of the treated peripheral artery became more distal.
Why the study?
Antiplatelet and anticoagulant therapy are commonly used around peripheral arterial endovascular intervention, but contemporary practice patterns needed to be established.
Cross-Sectional (n=162)
Yes
There is widespread international variation in antithrombotic therapy practices following peripheral arterial endovascular interventions, highlighting the need for randomized trials.
Answers are grounded in this paper and cite their sources.
Anatomical level shapes antiplatelet choice in peripheral interventions; extends evidence on practice patterns and supports location-specific trials.
BACKGROUND: Antiplatelet and anticoagulant therapy are commonly used before, during and after peripheral arterial endovascular intervention. This survey aimed to establish antiplatelet and anticoagulant choice for peripheral arterial endovascular intervention in contemporary clinical practice. METHODS: Pilot-tested questionnaire distributed via collaborative research networks. RESULTS: One hundred and sixty-two complete responses were collected from responders in 22 countries, predominantly the UK (48%) and the rest of the European Union (44%). Antiplatelet monotherapy was the most common choice pre-procedurally (62%). In the UK, there was no difference between dual and single antiplatelet therapy use post procedure (50% vs. 37% p = 0.107). However, a significant majority of EU respondents used dual therapy (68% vs. 20% p < 0.001). There was variation in choice of antiplatelet therapy by the device used and the anatomical location of the intervention artery. The majority (82%) of respondents believed there was insufficient evidence to guide antithrombotic therapy after peripheral endovascular intervention and most (92%) would support a randomised trial. CONCLUSIONS: There is widespread variation in the use of antiplatelet therapy, especially post peripheral arterial endovascular intervention. Clinicians would support the development of a randomised trial comparing dual antiplatelet therapy with monotherapy.
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Wong et al. (2019) conducted a cross-sectional in Peripheral arterial endovascular intervention (n=162). Distal anatomical level of peripheral arterial intervention vs. Proximal anatomical level was evaluated on Preference for dual antiplatelet therapy over monotherapy per anatomical level of artery treated more distally (OR 5.8, 95% CI 3.5-11.3, p=<0.001). Clinicians demonstrated a higher preference for dual antiplatelet therapy over monotherapy as the anatomical level of the treated peripheral artery became more distal.
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