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[外周血管系统介入手术的药物治疗]

[Medicinal therapy for interventional surgery of the peripheral vascular system].

作者信息

Tacke J, Lindhoff-Last E

机构信息

Institut für Diagnostische und Interventionelle Radiologie/Neuroradiologie, Klinikum Passau, Innstr. 76, 94032 Passau, Deutschland.

出版信息

Radiologe. 2010 Jan;50(1):44-7. doi: 10.1007/s00117-009-1916-x.

Abstract

The aim of medicinal treatment, during and after femoral and crural interventions is to prevent early or late onset arterial thrombosis of the treated vascular segments. Therefore, unfractionated heparin is administered during the intervention by an intra-arterial or intravenous approach. To avoid late onset thrombosis, administration of platelet function inhibitors is recommended. However, valid data are only available for acetylsalicylic acid (ASA). Therefore, ASA is recommended for long term medication. In several cardiological studies on stent implantation in coronary vessels the combination of ASA and clopidogrel for dual platelet inhibition has been proven to be effective. These results have been transferred to antithrombotic therapy of the lower extremities despite the lack of dedicated studies. There is no evidence for the use of vitamin K antagonists after peripheral interventions.

摘要

在股部和小腿部介入治疗期间及之后,药物治疗的目的是预防所治疗血管段的早期或晚期动脉血栓形成。因此,在介入治疗期间通过动脉内或静脉内途径给予普通肝素。为避免晚期血栓形成,建议使用血小板功能抑制剂。然而,仅有关于乙酰水杨酸(ASA)的有效数据。因此,推荐ASA用于长期用药。在多项关于冠状动脉支架植入的心脏病学研究中,已证实ASA与氯吡格雷联合用于双重血小板抑制是有效的。尽管缺乏专门研究,但这些结果已应用于下肢抗栓治疗。目前尚无证据支持在周围血管介入治疗后使用维生素K拮抗剂。

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