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• W3201916629 abstract "The use of warfarin for anticoagulation in thromboembolic disease has been the mainstay of treatment. Direct oral anticoagulants (DOACs) have shown to have equivalent anticoagulant effects, without increased bleeding risks or need for frequent monitoring. However, the role of DOACs remains unclear as an alternative to warfarin for high-risk peripheral artery disease (PAD) interventions. The purpose of this study is to evaluate the efficacy of DOACs compared to warfarin during the postoperative period in patients that underwent a high-risk lower extremity bypass (HRB). We performed an institutional review board-approved retrospective review of all lower extremity HRB patients at a single center from January 2012 to December 2020, who had previously been prescribed or started anticoagulant medication. The HRB group included all patients who had undergone femoral to above- or below-the-knee bypass with an adjunct procedure or below-the-knee bypass with a synthetic or composite vein conduit. All demographics, preoperative factors, and complications were summarized using frequencies and proportions and compared using the Fisher exact test. Age, medians and 25th-75th percentiles were used, and compared across groups using the Mann-Whitney U statistic. A series of multivariate binary logistic regression analyses were run to test the effect of individual covariates on the predictive ability of anticoagulation group on patency. A total of 44 patients (28 males; average age over 65 years) underwent a HRB during the study period. There were no significant differences in demographics and preoperative characteristics between the two groups. Among patient comorbidities, coronary artery disease was found to be significantly higher in patients on DOACs (P = .03). The 12-month primary patency rate was 83.3% vs 57.1%, for DOAC vs warfarin respectively (P = .03). The patients who had undergone lower extremity HRB with postoperative DOAC therapy exhibited greater graft patency rates compared with those receiving warfarin. Due to a more consistent therapeutic anticoagulation dosing, DOACs should be considered as a safe and possibly more effective alternative to warfarin the postoperative period for patients with HRB." @default.
• W3201916629 created "2021-10-11" @default.
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• W3201916629 date "2021-10-01" @default.
• W3201916629 modified "2023-09-23" @default.
• W3201916629 title "Effect of Direct Oral Anticoagulants Versus Warfarin on Patency in High-Risk Bypass Patients" @default.
• W3201916629 doi "https://doi.org/10.1016/j.jvs.2021.07.059" @default.
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