[Is antiaggregation with platelet function inhibitors indicated for prophylaxis in asymptomatic atherosclerotic plaques? - A position paper by the Professional Association of Vascular Surgeons in Private Practice (BNG)].

Antiaggregation with platelet function inhibitors (PFI) is an integral part of secondary prevention in patients with clinically manifest atherosclerotic vascular disease. The role of PFI in primary prevention is controversial. The current guidelines on peripheral arterial disease (PAD) and carotid stenosis recommend that patients who are clinically asymptomatic regarding vascular disease should not take PFI. However, the data on which this decision is based has a low level of evidence, and other international guidelines recommend antiaggregation in any case of plaques in the carotid.The present analysis of the literature shows that the blanket statement that patients with asymptomatic carotid atherosclerosis (stenosis degree <50%) and PAD do not require prophylactic PFI neither considers the extent nor the morphology of the underlying atherosclerosis. The indication for PFI in patients with asymptomatic atherosclerosis should always be determined individually, considering both the extent of the atherosclerosis and the personal risk of bleeding and ischemia.