This study states that It would be very interesting to see how many vascular surgeons follow these recommendations, especially regarding prosthetic bypasses (do you prescribe clopidogrel to these patients?) and vein bypasses (do you maintain these patients on anticoagulants?). I do not routinely do either, because I have not been particularly impressed by the data to routinely follow these guidelines. However, I add an anticoagulant in patients undergoing a vein bypass with disadvantaged outflow or a borderline diameter conduit. I have been surprised by how many general practitioners treat patients with PAD with ASA and rivaroxaban since that article was published. In my review in JVS Vantage Point (July 2020), I mentioned the difference in the composite beneficial outcomes between the rivaroxaban group and the control group was only about 3%. According to two different sets of criteria, the incidence of major bleeding was about 1% to 2% higher in the group than in the control group. Is it better to treat thousands of patients who undergo lower extremity revascularization with both aspirin and rivaroxaban as opposed to aspirin alone.

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