目的:评估下肢动脉硬化闭塞症患者腔内治疗术后应用不同抗栓方案的安全性、有效性和差异性。方法:选取2018年11月至2019年10月南京鼓楼医院血管外科收治的201例下肢动脉硬化闭塞症患者进行前瞻性队列研究，根据患者术后用药情况，将患者分为双联抗血小板组（A组，54例）、阿司匹林联合西洛他唑组（B组，70例）以及利伐沙班联合西洛他唑组（C组，77例）。统计分析三组患者的术前及术后3、6个月随访资料。结果:三组患者随访期间ABI、Rutherford分级、下肢动脉栓塞发生率及截肢率差异无统计学意义（n P均>0.05）。C组患者术后3、6个月靶血管通畅率均较A组高，差异有统计学意义（术后3个月n P=0.010，术后6个月n P=0.009）。A组与C组临床驱动靶血管重建发生率差异有统计学意义（n P=0.046）。三组患者出血事件发生率、心脑血管事件发生率差异无统计学意义（n P均>0.05）。n 结论:利伐沙班联合西洛他唑治疗方案相较于双联抗血小板治疗方案可以降低临床驱动血管重建概率，提高一期通畅率，并且短期内出血风险未见增加。“,”Objective:To evaluate the safety, efficacy and difference of different antithrombotic therapies for patients with lower extremity arteriosclerosis obliterans after endovascular treatment.Methods:A prospective cohort study was performed on 201 patients with arteriosclerosis obliterans in the lower extremity at the Department of Vascular Surgery of Nanjing Drum Tower Hospital from November 2018 to October 2019. The patients were divided into three groups based on the postoperative medications: dual antiplatelet treatment group (Group A, n n=54), aspirin-cilostazol combination treatment group (Group B, n n=70) and rivaroxaban-cilostazol combination treatment group (Group C, n n=77). The general data, baseline data and follow-up data of 3 months and 6 months after operation were collected. Statistical methods such as analysis of variance, chi-square test, rank sum test were employed to analyze the relevant data to evaluate the safety, efficacy and difference of the three treatment methods.n Results:There was no significant difference in the general data and baseline data (including preoperative data, surgical methods, and postoperative data) of the three groups of patients (n P>0.05). There was no significant difference in ABI, Rutherford classification, incidence of lower extremity arterial embolism, and amputation rate among the three groups of patients during follow-up (alln P>0.05). The target vessel patency rate was significantly higher in Group C than in Group A (n P=0.01 at 3 months postoperatively, n P=0.009 at 6 months postoperatively), and the incidence of clinically driven target vessel reconstruction was significantly different (n P=0.046). There was no significant difference in the bleeding rate and the incidence of cardiovascular and cerebrovascular diseases among the three groups of patients (all n P>0.05).n Conclusion:Compared with dual antiplatelet therapy, rivaroxaban-cilostazol combination therapy can reduce the probability of clinically driven vascular reconstruction, improve the patency rate at the first stage and doesn’t not increase the risk of bleeding in the short term.