Cor Vasa 2021, 63(6):748-759 | DOI: 10.33678/cor.2021.131

(Antithrombotic therapies in aortic and peripheral arterial diseases in 2021: a consensus document from the ESC working group on aorta and peripheral vascular diseases, the ESC working group on thrombosis, and the ESC working group on cardiovascular pharmacotherapy. Translation of the document prepared by the Czech Society of Cardiology and the Czech Society of Angiology of ČLS JEP)

Miloš Táborský^a, Aleš Linhart^b, Debora Karetová^b, Tomáš Skála^a, Zuzana Moťovská^c, Martin Köcher^d, Petr Štádler^e

^a I. interní klinika - kardiologická, Lékařská fakulta Univerzity Palackého a Fakultní nemocnice Olomouc, Olomouc

^b II. interní klinika kardiologie a angiologie, 1. lékařská fakulta Univerzity Karlovy a Všeobecná fakultní nemocnice v Praze, Praha

^c Kardiologická klinika, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, Praha

^d Radiodiagnostická klinika, Lékařská fakulta Univerzity Palackého a Fakultní nemocnice Olomouc, Olomouc

^e Oddělení cévní chirurgie, Nemocnice Na Homolce, Praha

The aim of this collaborative document is to provide an update for clinicians on best antithrombotic strategies in patients with aortic and/or peripheral arterial diseases. Antithrombotic therapy is a pillar of optimal medical treat- ment for these patients at very high cardiovascular risk. While the number of trials on antithrombotic therapies in patients with aortic or peripheral arterial diseases is substantially smaller than for those with coronary artery disease, recent evidence deserves to be incorporated into clinical practice. In the absence of specific indications for chronic oral anticoagulation due to concomitant cardiovascular disease, a single antiplatelet agent is the basis for long-term antithrombotic treatment in patients with aortic or peripheral arterial diseases. Its association with another antiplatelet agent or low-dose anticoagulants will be discussed, based on patient's ischaemic and bleeding risk as well therapeutic paths (e.g. endovascular therapy). This consensus document aims to provide a guidance for antithrombotic therapy according to arterial disease localizations and clinical presentation. However, it cannot substitute multidisciplinary team discussions, which are particularly important in patients with uncertain ischaemic/bleeding balance. Importantly, since this balance evolves over time in an individual patient, a regular reassessment of the antithrombotic therapy is of paramount importance.

Keywords: Anticoagulant, Antiplatelet drug, Antithrombotic therapy, Aorta, Artery, Lower-extremity artery disease, Mesenteric artery, Peripheral arterial disease, Renal artery, Subclavian artery, Vertebral artery, Thrombosis

Received: November 12, 2021; Revised: November 12, 2021; Accepted: November 14, 2021; Published: December 13, 2021  Show citation