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PAD-Lifestyle Priorities — USMLE Step 2 CK MCQ

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HardCardiologyPAD-Lifestyle PrioritiesUSMLE Step 2 CK

A 64-year-old man with symptomatic PAD undergoes successful femoropopliteal endovascular revascularization. He has no atrial fibrillation, active bleeding, prior intracranial hemorrhage, or other high-bleeding-risk feature. Which long-term antithrombotic strategy best reduces both cardiovascular and limb events?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Rivaroxaban 2.5 mg twice daily plus low-dose aspirin

A is correct: vascular-dose rivaroxaban 2.5 mg twice daily plus low-dose aspirin is recommended after lower-extremity revascularization in patients without increased bleeding risk to reduce major adverse cardiovascular and limb events. B uses the atrial-fibrillation dose without an indication. C adds full anticoagulation and bleeding without PAD benefit. D uses unsupported indefinite potent dual antiplatelet therapy. E leaves substantial thrombotic risk untreated.

Reference: 2024 AHA/ACC guideline for lower-extremity peripheral artery disease. https://professional.heart.org/en/science-news/2024-guideline-for-the-management-of-lower-extremity-peripheral-artery-disease/top-things-to-know