Key result
Aspirin plus dipyridamole shows no significant patency benefit over oral anticoagulants after femoropopliteal PTA.
Why the study?
It was uncertain whether anticoagulation or platelet inhibition treatment better prevents reobstruction after femoropopliteal PTA.
Does a combination of low-dose aspirin and dipyridamole improve patency compared to oral anticoagulants in patients after successful femoropopliteal PTA?
RCT (n=160)
Does a combination of low-dose aspirin and dipyridamole improve patency compared to oral anticoagulants in patients after successful femoropopliteal PTA?
Low-dose aspirin combined with dipyridamole provides comparable patency to oral anticoagulants after femoropopliteal PTA, but with a better safety profile regarding severe bleeding complications.
Hypothesis-generating for antiplatelet over anticoagulant therapy after femoropopliteal PTA; prospective RCTs needed before practice change.
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.
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D et al. (1994) conducted an RCT in Femoropopliteal percutaneous transluminal angioplasty (n=160). Low-dose acetylsalicylic acid and dipyridamole (ASAD) vs. Oral anticoagulants was evaluated on Patency (p=.18). Low-dose aspirin combined with dipyridamole resulted in 69% patency compared to 53% with oral anticoagulants after femoropopliteal PTA (P=0.18), with fewer severe bleeding complications.
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