Dr. Valentin Fuster discusses a study on the effects of low-dose rivaroxaban combined with aspirin in fragile patients after lower extremity revascularization, focusing on the balance between efficacy and safety. It highlights that while frailty increases the risk of adverse outcomes, rivaroxaban reduces ischemic events but also raises bleeding risks, regardless of frailty status. The editorial emphasizes that frailty should not preclude the use of combined antithrombotic therapy, advocating for personalized treatment approaches.