ABSTRACT
Patients with peripheral artery disease suffer from a high incidence of ischemic vascular
complications in coronary, cerebral, and peripheral vascular beds. Reduction of atherothrombotic
complications with aspirin or clopidogrel has proven to be successful. The role of
oral anticoagulants in patients with symptomatic peripheral artery is limited. Randomized
controlled trials comparing the effects of aspirin with oral anticoagulants are scarce.
Oral anticoagulants (International Normalized Ratio = 2.5 to 4.5) are more effective
than aspirin in preventing infrainguinal bypass occlusion only when venous graft material
is used and the bypass is considered to be at high risk for occlusion. Whether the
use of oral anticoagulants reduces all-cause morbidity and mortality is not unequivocally
clear. The risk of ischemic events is reduced at the expense of an increased number
of bleeding complications, which is one of the main reasons that therapy has not been
widely adopted.
KEYWORDS
Peripheral artery disease - oral anticoagulants - cardiovascular risk reduction
