The CLEAR (Considering Leading Experts’ Antithrombotic Regimes around peripheral angioplasty) survey: an international perspective on antiplatelet and anticoagulant practice for peripheral arterial endovascular intervention

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Abstract

BackgroundAntiplatelet and anticoagulant therapy are commonly used before, during and after peripheral arterial endovascular intervention. This survey aimed to establish antiplatelet and anticoagulant choice for peripheral arterial endovascular intervention in contemporary clinical practice.
MethodsPilot-tested questionnaire distributed via collaborative research networks.
ResultsOne hundred and sixty-two complete responses were collected from responders in 22 countries, predominantly the UK (48%) and the rest of the European Union (44%). Antiplatelet monotherapy was the most common choice pre-procedurally (62%). In the UK, there was no difference between dual and single antiplatelet therapy use post procedure (50% vs. 37% p=0.107). However, a significant majority of EU respondents used dual therapy (68% vs. 20% p<0.001). There was variation in choice of antiplatelet therapy by the device used and the anatomical location of the intervention artery. The majority (82%) of respondents believed there was insufficient evidence to guide antithrombotic therapy after peripheral endovascular intervention and most (92%) would support a randomised trial. 
ConclusionsThere is widespread variation in the use of antiplatelet therapy, especially post peripheral arterial endovascular intervention. Clinicians would support the development of a randomised trial comparing dual antiplatelet therapy with monotherapy. 
Original languageEnglish
Number of pages7
JournalCVIR Endovascular
Volume2
Issue number37
Early online date12 Nov 2019
Publication statusPublished - 1 Dec 2019

Keywords

  • platelet aggregation inhibitors
  • peripheral arterial disease
  • endovascular procedures
  • surveys and questionnaires

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