Wong Kitty H F, Bosanquet Dave C, Ambler Graeme K, Qureshi Mahim I, Hinchliffe Robert J, Twine Christopher P
Bristol Centre for Surgical Research, University of Bristol, Bristol, BS8 2PS, UK.
North Bristol NHS Trust, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK.
CVIR Endovasc. 2019 Nov 12;2(1):37. doi: 10.1186/s42155-019-0079-8.
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.
Pilot-tested questionnaire distributed via collaborative research networks.
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.
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.
抗血小板和抗凝治疗常用于外周动脉血管腔内介入治疗的术前、术中和术后。本调查旨在确定当代临床实践中外周动脉血管腔内介入治疗的抗血小板和抗凝药物选择。
通过合作研究网络分发经过预测试的问卷。
从22个国家的受访者中收集到162份完整回复，主要来自英国（48%）和欧盟其他国家（44%）。抗血小板单药治疗是术前最常见的选择（62%）。在英国，术后双联和单联抗血小板治疗的使用情况没有差异（50%对37%，p = 0.107）。然而，绝大多数欧盟受访者使用双联治疗（68%对20%，p < 0.001）。抗血小板治疗的选择因所用器械和介入动脉的解剖位置而异。大多数（82%）受访者认为外周血管腔内介入治疗后抗栓治疗的证据不足，大多数（92%）受访者支持进行一项随机试验。
抗血小板治疗的使用存在广泛差异，尤其是在外周动脉血管腔内介入治疗后。临床医生支持开展一项比较双联抗血小板治疗与单药治疗的随机试验。
