Praxis der Thrombozyten-Aggregationshemmung nach Katheterintervention der Becken- / Beinarterien in Deutschland

Zusammenfassung

Hintergrund und Fragestellung | Die Durchführung der Thrombozytenaggregationshemmung mit zwei verschiedenen Substanzen, die sogenannte duale Thrombozytenaggregationshemmung, nach peripherer arterieller Intervention ist aufgrund der mangelnden Studienlage weder in nationalen noch internationalen Leitlinien geregelt.

Methodik | Mittels eines standardisierten Evaluationsbogens wurden 212 Kliniken / Gefäßzentren in Deutschland bezüglich der Praxis der dualen Thrombozytenaggregationshemmung nach peripherer arterieller Intervention befragt. Die Evaluation erfolgte differenziert nach Lokalisation des intervenierten Gefäßsegmentes und Interventionsmethode.

Ergebnisse | Es wurden 89 Evaluationsbögen (42 %) beantwortet und zurückgesendet. Die Durchführung und Dauer der dualen Thrombozytenaggregationshemmung nach Intervention peripherer Arterien ist vor allem im Hinblick auf die unterschiedlichen Therapiemethoden (PTA: perkutane transluminale Angioplastie, DCB-PTA: Drug Coated Ballon, Stentintervention, DES: Drug Eluting Stent, Atherektomie) sehr heterogen. Die Dauer der dualen Thrombozytenaggregationshemmung betrug im Median für die alleinige PTA: iliacal / femoro-popliteal 0 Monate, crural 1 Monat, für die DCB-Intervention und Stentimplantation: iliacal 1 Monat, femoro-popliteal 1,5 Monate, crural 2 Monate; nach DE-Stentimplantation: iliacal 1,5 Monate, femoro-popliteal und crural 3 Monate, nach Atherektomie: femoro-popliteal und crural 1 Monat.

Folgerung | Die Datenlage bezüglich der dualen Thrombozytenaggregationshemmung nach Intervention der peripheren Arterien ist unzureichend.

Abstract

Background and aim: Guideline recommendations regarding antithrombotic treatment with two antiplatelet agents (dual antiplatelet treatment) after peripheral interventional procedures are vague due to missing data from clinical trials.

Methods: 212 vascular centres in germany were evaluated regarding dual antiplatelet treatment using a standardized questionnaire with differentiation of localisation of the treated artery and interventional methods being used.

Results: 89 (42 %) questionnaires returned completed. Application and duration of dual antiplatelet treatment after peripheral interventional procedures were quite different regarding interventional methods used (PTA: percutaneous transluminal angioplasty, DCB-PTA: drug coated ballon, Stenting, DES: drug eluting stent, Atherectomy). Mean duration of dual antiplatelet treatment were: PTA iliacal / femoro-popliteal 0 month, crural 1 month; DCB-Intervention and stenting: iliacal 1 month, femoro-popliteal 1,5 months, crural 2 months; DE-stenting iliacal 1,5 months, femoro-popliteal / crural 3 months and after femoro-popliteal / crural atherectomy 1 month.

Conclusion: Data about dual antiplatelet treatment after peripheral interventional procedures are sparse.

Schlüsselwörter

Intervention - duale Thrombozytenaggregationshemmung - periphere arterielle Verschlusskrankheit

Keywords

Intervention - dual antiplatelet treatment - peripheral artery disease

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