Trani Antonio, Benedetto Pietro, Di Leo Ferdinando, Baiano Angela, Esposito Andrea, Menna Danilo, Allegretti Arianna, Cappiello Pierluigi Antonino, Dell'Edera Domenico
Vascular and Endovascular Surgery Unit, Cardiovascular Department, San Carlo Hospital Potenza, via Potito Petrone, 85100 Potenza, Italy.
Cytogenetic and Molecular Genetics Unit, "Madonna delle Grazie" Hospital, 75100 Matera, Italy.
J Pharm Health Care Sci. 2020 Aug 3;6:17. doi: 10.1186/s40780-020-00173-9. eCollection 2020.
Many patients with critical lower limb ischemia are not eligible for revascularization procedures. Still, given the emerging role of both platelet and coagulation activation in the formation of arterial thrombi, they may benefit from the novel anticoagulant and antiplatelet drugs.
We describe the case of a male with critical lower limb ischemia complicated by older age, frailty, polymorbidity and non valvular atrial fibrillation, who was deemed as non eligible for surgery. The patient was successfully treated with the combination of rivaroxaban and cilostazol, and the clinical benefit was maintained throughout 32 months, with no occurrence of major or minor hemorrhagic or thrombotic events.
To our knowledge, this is the first report on the efficacy and safety of such a combination therapy in critical lower limb ischemia. In a clinical setting in which alternative pharmacological approaches are urgently needed, the association of rivaroxaban and cilostazol warrants further investigations.
许多严重下肢缺血患者不符合血管重建手术的条件。然而，鉴于血小板和凝血激活在动脉血栓形成中的新作用，他们可能从新型抗凝和抗血小板药物中获益。
我们描述了一名患有严重下肢缺血并伴有高龄、身体虚弱、多种疾病和非瓣膜性心房颤动的男性患者，该患者被认为不适合手术。该患者接受利伐沙班和西洛他唑联合治疗成功，临床获益持续32个月，未发生任何重大或轻微出血或血栓事件。
据我们所知，这是关于这种联合治疗在严重下肢缺血中的疗效和安全性的首次报告。在迫切需要替代药物治疗方法的临床环境中，利伐沙班和西洛他唑的联合应用值得进一步研究。
