BENEFIT OF HYPOCOAGULATION AFTER LOWER LIMB BYPASS - A SYSTEMATIC REVIEW

Authors

  • Vitor Ferreira Serviço de Angiologia e Cirurgia Vascular, Hospital de Santo António — Centro Hospitalar do Porto
  • Cristiana Freixo Laboratório de Farmacologia Clínica da Faculdade de Medicina da Universidade de Lisboa
  • Joana Martins Serviço de Angiologia e Cirurgia Vascular, Hospital de Santo António — Centro Hospitalar do Porto
  • Duarte Rego Serviço de Angiologia e Cirurgia Vascular, Hospital de Santo António — Centro Hospitalar do Porto
  • João Gonçalves Serviço de Angiologia e Cirurgia Vascular, Hospital de Santo António — Centro Hospitalar do Porto
  • Gabriela Teixeira Serviço de Angiologia e Cirurgia Vascular, Hospital de Santo António — Centro Hospitalar do Porto
  • Inês Antunes Serviço de Angiologia e Cirurgia Vascular, Hospital de Santo António — Centro Hospitalar do Porto
  • Carlos Veiga Serviço de Angiologia e Cirurgia Vascular, Hospital de Santo António — Centro Hospitalar do Porto
  • Daniel Mendes Serviço de Angiologia e Cirurgia Vascular, Hospital de Santo António — Centro Hospitalar do Porto
  • Rui Almeida Serviço de Angiologia e Cirurgia Vascular, Hospital de Santo António — Centro Hospitalar do Porto; Instituto de Ciências Biomédicas Abel Salazar — Universidade do Porto

DOI:

https://doi.org/10.48750/acv.86

Keywords:

Anticoagulants, peripheral arterial disease, primary patency

Abstract

Introduction: After surgical revascularization of the lower limb, antiplatelet agents are usually prescribed and anticoagulation is considered in cases of high risk of thrombosis. We conducted a systematic literature review of the existing evidence on long term prescription of anticoagulants in the postoperative.

Material and methods: Systematic review of the literature available in the Pubmed database.

Results: The studies selected for the final review consisted of: 6 randomized controlled trials (and 4 post-hoc analyzes), 1 prospective study with historical controls and 3 retrospective studies.

Conclusion: The efficacy of hypocoagulation depends on the conduit used and its intrinsic factors. There is benefit of hypocoagulation in the autologous venous lower limb bypasses, but the INR range and risk factors for thrombosis may influence the results. In the non-venous grafts there may be benefit in those with reduced caliber and low average flow. The incidence of major bleeding is significant, and a careful evaluation of the risk-benefit ratio in the prescription of chronic hypocoagulation is essential.

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References

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Published

2018-12-02

How to Cite

1.
Ferreira V, Freixo C, Martins J, Rego D, Gonçalves J, Teixeira G, Antunes I, Veiga C, Mendes D, Almeida R. BENEFIT OF HYPOCOAGULATION AFTER LOWER LIMB BYPASS - A SYSTEMATIC REVIEW. Angiol Cir Vasc [Internet]. 2018 Dec. 2 [cited 2024 Mar. 28];14(1):61-7. Available from: https://acvjournal.com/index.php/acv/article/view/86

Issue

Section

Review Article