A Review of Antithrombotic Therapies for Patients with Chronic Peripheral Arterial Disease and after Revascularization

Abstract

Peripheral arterial disease (PAD) represents a major health issue that significantly impacts patient’s survival and quality of life. In addition to limb-related events, patients with PAD have an increased risk of myocardial infarction, stroke, and death. However, compared with coronary and cerebrovascular disease, studies addressing optimal risk reduction modalities including antithrombotic therapies in patients with PAD have been underrepresented in the literature. This publication serves as a narrative review of existing evidence on the effectiveness of antithrombotic therapy in patients with PAD. In patients with chronic stable PAD or post-revascularization, antithrombotic therapies including single or dual antiplatelet agents, anticoagulation, or a combination of these treatments have been shown to reduce cardiovascular and limb events. This narrative review provides a summary of the available literature on the management of patients with PAD, categorized into treatment strategies for chronic, post-endovascular treatment, and post-open surgical revascularization and to discuss the antithrombotic protocol utilized at our institution while providing a rational for our treatment algorithm.