Short-term effects of rivaroxaban combined with aspirin in the treatment of lower limb arterial atherosclerosis occlusion with stent placement: A retrospective study

This study evaluates the short-term effects of rivaroxaban combined with aspirin in treating lower limb arterial atherosclerosis occlusion after stent placement. Between July 2018 and December 2022, 141 patients with lower limb arterial atherosclerosis occlusion underwent stent placement and were divided into 2 groups based on the different treatments documented in the cases. The clopidogrel group (n = 70) received clopidogrel sulfate plus aspirin, while the rivaroxaban group (n = 71) received rivaroxaban plus aspirin. Outcomes included 1-year patency rate, bleeding events, acute embolism, amputation rates, coagulation indicators, and thromboelastography (TEG) parameters. The 1-year patency rate at 6 months postoperatively was higher in the rivaroxaban group (92.96%) compared to the clopidogrel group (P < .05). Both groups showed increased activated partial thromboplastin time (APTT) and prothrombin time (PT) and decreased D-dimer (D-D) and fibrinogen (FIB) levels after 6 months (P < .05). APTT and PT were higher, while D-D and FIB were lower in the rivaroxaban group (P < .05). TEG parameters showed increased reaction time (R), clot formation time (K), and clot index (CI) and decreased alpha angle (α), maximum amplitude (MA), and thromboelastometry (G) in both groups at 6 months. R, K, and CI were higher, and α, MA, and G were lower in the rivaroxaban group (P < .05). Bleeding events were similar between groups (P > .05), with 1 embolism case in the rivaroxaban group vs 2 in the clopidogrel group. Rivaroxaban combined with aspirin post-stent placement improved vascular patency and anticoagulation outcomes without increasing bleeding risk, offering an effective treatment option for lower limb arterial atherosclerosis occlusion.