Peripheral artery disease carries a high risk of serious complications such as heart attacks, strokes, and amputations. This thesis shows that blood vessel damage can be measured easily and reliably using portable ultrasound devices. It also shows that a combination of blood thinners strongly reduces the risk of complications through stronger blood thinning, but does not reduce vessel damage or inflammation. Two large studies show that clopidogrel provides the best balance of effectiveness and safety for most patients, while combination therapy is useful for those who have undergone angioplasty or surgery in the leg. Personalized treatment based on genetic characteristics is promising but still needs further research. This thesis also shows that COVID-19 causes long-lasting changes in blood vessels, blood clotting, and inflammation for up to 18 months after infection. Damage to large blood vessels is not detectable with ultrasound, while subtle vessel changes and increased clotting activity remain visible in the blood.
Loes Willems (1993, Mook) studied Medicine at Radboud University Nijmegen (graduation 2018). She worked as a surgical resident at Radboudumc and Ziekenhuis Gelderse Vallei and as a PhD candidate at Radboudumc, researching vascular disease and COVID-19. She gained international research experience at New York University Langone Health and has been a vascular surgery resident at Helios Klinikum Berlin-Buch since 2024.