Why does he always ask about my Blood Thinners?

Antiplatelet medications are essential in the treatment of peripheral vascular disease (PVD) and your general vascular health. The most commonly prescribed antiplatelet medication is Aspirin (Cartia, Cardiprin, Astrix, Spren), but other “stronger” antiplatelet medications such as Clopidogrel (Plavix, Piax) or Tigacrelor (Brilintia) are often prescribed in isolation or in combination with aspirin. Antiplatelet drugs prevent platelets which are small cells in your blood stream and an integral part of your body’s clotting system from sticking together and decrease your body’s ability to form ‘unhealthy’ blood clots. 

These antiplatelet drugs are very different from anticoagulants or antithrombotic medications such as Warfarin, Xeralto (Rivaroxaban), Apixaban (Eliquis) and Dabigatran (Pradaxa) which are much more aggressive disruptors of the body’s ability for form clots and are used for different reasons and medical indications. 

Antiplatelet drugs, in a vascular setting are often used as a preventative medication if you have PVD but are essential following any arterial treatment, open or endovascular.

Antiplatelet drugs are essential in vascular disease for several reasons :

1. Prevent bloods clots forming : PVD often involves the narrowing or blockage of arteries in the limbs (usually the legs). Antiplatelet drugs, reduce the tendency of platelets in the blood to stick together and form clots. These clots can obstruct already narrowed blood vessels, leading to reduced blood flow and potentially causing pain, tissue damage, or even limb-threatening ischemia. Antiplatelet drugs are often used in combination with statins (cholesterol modifying drugs), anti-hypertensives and other medications to optimise vascular risk factors of progressive disease.

2. Lower Cardiovascular Risk:  People with PVD often have an increased risk of other cardiovascular events, like heart attacks and strokes. Antiplatelet therapy can help reduce this risk by inhibiting platelet aggregation not only in the peripheral arteries but also in the coronary and cerebral arteries.

3. Aid in Treatment : Antiplatelet medications are essential following open or endovascular arterial treatments. These procedures to improve you blood supply also cause temporary microscopic damage to the lining of your arteries or there is irritation to the lining of the arteries (intima) following stenting. This increases the risk of early complications. Antiplatelets (usually a combination of aspirin and clopidogrel) are used to minimise this rare risk. In the long term, antiplatelets help maintain the patency (openness) of treated vessels and reduce the risk of long term issues such as arterial occlusion (blockage)(usually in combination with a statin).

The duration and type of antiplatelets prescribed will depend on each patient and the intervention undertaken, however in most cases after a vascular procedure, most patients will remain on at least one antiplatelet drug indefinitely. The compliance and use of these prescribed drugs is essential. It is essential for patients with PVD to work closely with their healthcare providers to determine the most appropriate antiplatelet therapy and overall treatment plan, as the choice of medication and dosage can vary based on individual factors and the extent of the disease. 

Feel free to discuss this information with Mr Ponosh, your other specialists or your GP.


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