In peripheral interventions: Do you make any difference in use of antiplatelet therapy after bare metal stent / drug eluting stent / drug eluting balloon / covered stents? What is your regime like?
Tough question, unlike to coronary intervention, antithrombotic regimens for peripheral intervention are still debatable. Without other concomitant vascular disease (e.g. coronary or cerebral), 1 month ASS+clopidogrel and life long ASS will be sufficient for BMS. But in other cases, you should tailor drug regimen according to stent length, distal vascular bed, stent size and patient risk profiles.
Thank you for your opinion, Jang-Whan. As for iliac artery stenting we do implement a six-weeks dual antiplatelet regime, followed by life-long ASS. In our clinic regarding peripheral interventions we use the TIGRIS stent quite often, followed by dual regime for six months. Crural interventions generally, as well as interventions with DES are followed by loading dose clopidogrel plus six months dual antiplatelets, followed by ASS life-long.
Without other concomitant vascular diseases our procedures for peripherals are:
For BMS we give 4 weeks clopidogrel 75 and ASS100, followed by life-long ASS.
In case of propaten-covered prothesis (gore - viaban) we give ASS100 and clopidogrel 75 for 6 mths, followed by life-long ASS100.
In case of DEB we give ASS100 and clopidogrel 75 mg for 3 mths, followed by ASS100 life-long - due to the prolonged "epithelial wound". For DES same procedure like propaten-covered prothesis.
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