Clinical Study Of Antiplatelet Combined With Oral Anticoagulant To Prevent Restenosis After Stent Implantation In Lower Extremity Arteriosclerosis Obliterans

Objective:To investigate the safety and efficacy of anticoagulation and antiplatelet therapy in preventing restenosis after stent implantation in patients with arteriosclerosis obliterans(ASO).Methods:A total of 106 patients with ASO who received intracavitary treatment in the first Hospital of Shanxi Medical University from January 2017 to May 2021 were divided into rivaroxaban group(n = 48)and control group(n = 58)according to different postoperative antithrombotic regimens.The preoperative and postoperative follow-up data of the two groups were collected and analyzed,and the clinical efficacy and safety of the two groups were compared.Results:Comparison of general data: there was no significant difference in age,sex ratio,hypertension,diabetes,hyperlipidemia and TASC Ⅱ classification between the two groups.The patency rate of the first stage in the rivaroxaban group(95.83%)was higher than that in the control group(87.93%),but there was no significant difference in statistics(P > 0.05).(2)6 and 12 months after operation: the patency rate of rivaroxaban group(93.75%,85.42)was higher than that of the control group(79.31%,68.97%),and the difference was statistically significant(chi-square value was 4.508,3.94 respectively,P < 0.05).Comparison of lower limb adverse events: arterial embolism in 1 case(2.08%),amputation in 1 case(2.08%)in rivaroxaban group,2 cases in control group(3.44%),amputation in 1 case(1.72%),there was no significant difference between the two groups(P > 0.05).There was no significant difference in the indexes of APTT,PT and PLT between the two groups before operation and 6 and 12 months after operation.Three months after operation,the APTT index in the rivaroxaban group was significantly higher than that in the control group(P < 0.05),but there was no significant difference in PT and PLT indexes.Conclusion:For patients with ASO intracavitary stent implantation,rivaroxaban combined with aspirin therapy can effectively improve the postoperative patency rate.Compared with the double antiplatelet therapy,rivaroxaban combined with aspirin does not increase the risk of bleeding and is safe.