The Turkish Journal of Vascular Surgery

Yazarlar: Ayşe Gül KUNT, Okay Güven KARACA, Ata Niyazi ECEVİT, Yüksel ÇETiN, Mehmet KALENDER, Osman Tansel DARÇIN

Konular:-

Anahtar Kelimeler:Peripheral vascular surgery; anticoagulant treatment; mortality

Özet: Objective: Atherosclerotic peripheral arterial disease is associated with an increased risk of myocardial infarction, stroke, and death from cardiovascular causes. Antiplatelet drugs protect from major cardiovascular events, but the role of oral anticoagulant agents is unclear in the prevention of cardiovascular complications in patients with peripheral arterial disease. Material and Methods: We assigned patients with peripheral arterial disease treated surgically. According to the medical treatment in postoperative and follow-up periods, the patients were divided into two groups: Anti- coagulant therapy [patients receiving oral anticoagulant agents with a target international normal- ized ratio (INR)=2.0-3.0, n=78] and the patients not receiving oral anticoagulant agents (n=56). In both groups, medical treatment was combined with antiplatelet therapy in some patients. The primary outcome was death and secondary outcome was limb amputation. Results: A total of 134 patients were treated surgically. The mean follow-up period was 30 months. Revision due to bleeding, occlusion of the graft, embolism of non-treated arteries, myocardial infarction and stroke occurred in 6 patients receiving anticoagulant therapy (7.69%) and in 5 patients not receiving anticoagulant therapy (8.92%, p=0.48). Death and limb amputation occurred only in patients not receiving anticoagulant therapy (12.5%, p=0.02 and 5.4%, p=0.071). Conclusion: In patients with peripheral arte- rial disease treated surgically, the oral anticoagulant therapy may be effective for preventing death.

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