Factors enhancing risk of limb loss after surgical revascularization are:
- Infrainguinal bypass using prosthetic material
- Bypass below the knee
- Use of suboptimal conduit
- Poor arterial runoff
- Extensive lesion
Measures to prevent limb loss after surgical revascularization
When these risk factors are noted, antithrombotic therapy can be intensified by adding either rivaroxaban or warfarin to aspirin. Another option is to give dual antiplatelet therapy. While intensifying therapy, risk of limb loss should be weighed against the potential bleeding risk in each individual. Triple therapy with two antiplatelet agents and one anticoagulant is better avoided in view of high bleeding risk.