TH4.8 Antiplatelet therapy used in vascular patients post CEA

Abstract

Aims To review antiplatelet therapy of vascular patients who had undergone CEA post TIA over a 1-year period and to compare their antiplatelet therapy to European Society of Vascular Surgery (ESVS) guidelines for atherosclerotic carotid disease. Methods We reviewed all patients admitted under the vascular team who underwent elective CEA from 1/1/20 to 1/1/21 (n=65). We reviewed the antiplatelet therapy that were prescribed on discharge summaries, and compared to current ESVS guidance. According to ESVS guidance, it is stated that dual antiplatelet therapy (DAPT) is not recommended in patients undergoing carotid endarterectomy unless indicated for cardiac reasons. Results Out of the 65 patients who were discharged over one year, 55% were discharged on DAPT, with the remaining 45% prescribed either aspirin or clopidogrel alone. Additionally, there was heterogeneity in the treatment duration for antiplatelet therapy across patients. However, on 3 month follow up appointments, 100% of patients were advised to continue on SAPT long-term in accordance to guidance. Conclusions Given the heterogeneity in treatment plans for CEA patients over the studied time period, we believe there is value in introducing weekly teaching sessions for MDT members of all grades, to keep all members up to date on current guidance. Additionally, use of posters incorporating up to date antiplatelet therapy guidance may also serve as a useful tool for doctors discharging post CEA patients. Despite the heterogeneity noted on discharge summaries, 100% of patients were advised to continue on SAPT long term in follow up clinic appointments.