Debora Karetová
Patients with peripheral atherosclerosis carry a high risk of cardiovascular events and, at the same time, may be at risk of limb viability. The basis of their antithrombotic treatment is anti-platelet monotherapy by clopidogrel or acetylsalicylic acid. In patients after endovascular interventions we administer dual treatment (DAPT – dual antiplatelet therapy) for 1-6 months, based on the intervention specialist’s recommendation. In patients with high ischemic risk (whether total or limb related), we may leave the patient on antiplatelet medication even for a longer time or alternatively consider the combination of acetylsalicylic acid (ASA) with oral anticoagulant rivaroxaban at reduced dose (DAT – dual antithrombotic therapy). After surgical peripheral revascularization, antiplatelet monotherapy is the basis for treatment. However, in risk bypasses the above management can be combined with oral anticoagulant treatment (rather in venous bypasses) or double antiplatelet medication (rather in prosthetic bypasses). Stable, uncomplicated patients with peripheral atherosclerosis are left to this medication alone, without the need for an antiaggregation if they have an indication of anticoagulant therapy for cardiac or other reasons.