Peripheral Arterial Procedures and Postinterventional Prophylaxis

Abstract

In patients with peripheral arterial disease (PAD), prophylaxis is indicated after any vascular intervention to prevent acute thrombotic occlusion, as well as recurrent stenosis due to intimal hyperplasia or progressive arteriosclerosis. In contrast to coronary and carotid interventions, there is no standardized regime established or even recommended after peripheral arterial interventions. Coronary interventions are performed by cardiologists only, while peripheral interventions are conducted by radiologists, cardiologists, angiologists, and vascular surgeons. However, radiologists and vascular surgeons are not trained in the management of atherosclerotic risk factors. In this editorial, I discuss the lack of a specific prophylaxis protocol after transcatheter interventions and bypass surgery. Issues to be considered are whether postinterventional prophylaxis depends on the type of transluminal or surgical procedure and whether such a regime can be the same in each patient. Finally, the need for a comprehensive concept is examined, including the management of atherosclerotic risk factors.