Cilostazol Prevents Progression of Asymptomatic Carotid Artery Stenosis in Patients with Contralateral Carotid Artery Stenting

Kato, Toru; Sakai, Hideki; Takagi, Toshinori; Nishimura, Yasuaki

doi:10.3174/ajnr.a2955

Cited by 7 publications

(11 citation statements)

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“…Six reports [17][18][19][20][21][22] presented data regarding the rate of ISR after CAS. As shown in Table 1, criteria for ISR diagnosis were similar in the analyzed studies.…”

Section: Resultsmentioning

confidence: 99%

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Meta-Analysis of Studies Evaluating the Effect of Cilostazol on Major Outcomes After Carotid Stenting

et al. 2015

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Purpose: To evaluate the effect of cilostazol on major outcomes after carotid artery stenting (CAS). Methods: A systematic literature review was conducted conforming to established criteria in order to identify articles published prior to May 2015 evaluating major post-CAS outcomes in patients treated with cilostazol vs patients not treated with cilostazol. Major outcomes included in-stent restenosis (ISR) within the observation period, the revascularization rate, major/minor bleeding, and the myocardial infarction/stroke/death rate (MI/stroke/death) at 30 days and within the observation period. Data were pooled for all studies containing adequate data for each outcome investigated; effect estimates are presented as the odds ratios (ORs) and 95 confidence intervals (CI). Results: Overall, 7 studies pertaining to 1297 patients were eligible. Heterogeneity was low among studies so a fixed-effect analysis was conducted. Six studies (n=1233) were compared for the ISR endpoint, showing a significantly lower ISR rate with cilostazol treatment after a mean follow-up of 20 months (OR 0.158, 95% CI 0.072 to 0.349, p<0.001). Five studies (n=649) were compared regarding 30-day MI/stroke/death (OR 0.724, 95% CI 0.293 to 1.789, p=0.484) and 3 studies (n=1076) were analyzed regarding MI/stroke/death within the entire followup period (OR 0.768, 95% CI 0.477 to 1.236, p=0.276); no significant difference was found between the groups. Data on bleeding rates and revascularization rates post ISR were inadequate to conduct further analysis. Conclusion: Cilostazol seems to decrease total ISR rates in patients undergoing CAS without affecting MI/stroke/death events, both in the early and late settings.

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“…Six reports [17][18][19][20][21][22] presented data regarding the rate of ISR after CAS. As shown in Table 1, criteria for ISR diagnosis were similar in the analyzed studies.…”

Section: Resultsmentioning

confidence: 99%

“…After applying the inclusion/exclusion criteria, 7 controlled clinical trials [16][17][18][19][20][21][22] were identified as appropriate for analysis and 268 studies were excluded ( Figure 1). All included trials were published within the past 5 years (2010-2015).…”

Section: Study Selection and Outcomesmentioning

confidence: 99%

Meta-Analysis of Studies Evaluating the Effect of Cilostazol on Major Outcomes After Carotid Stenting

et al. 2015

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“…In addition, the incidence of hemorrhagic events was 1.2% in the aspirin group versus 0.036% in the CLZ group, demonstrating the superiority of CLZ. Recently Kato et al 25 reported that CLZ also significantly prevented progression of contralateral asymptomatic carotid artery stenosis in 95 patients treated by CAS. It might be worthwhile to recommend the life-long use of CLZ rather than aspirin as the antiplatelet agent after CAS.…”

Section: Discussionmentioning

confidence: 99%

Effect of Cilostazol in Preventing Restenosis after Carotid Artery Stenting Using the Carotid Wallstent: A Multicenter Retrospective Study

Takayama

Taoka

Nakagawa

et al. 2012

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Restenosis after CAS is a postoperative problem, with a reported frequency of approximately 2%-8%. However differences in stent design, procedure, and the antiplatelet agent appear to affect the incidence of restenosis. We assessed the frequency of restenosis and the effect of the antiplatelet agent CLZ in preventing restenosis after CAS by the standard procedure using the CWS.

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“…18 Kato ve ark., 2012 yılında yayımlanan, karotis arter stentleme yapılmış ve kontralateral karotis arterlerinde asemptomatik stenozu olan hastaların stenozlarını inceledikleri çalışma-larında, silostazol kullanan hastalarda stenoz progresyonu gözlenen hasta sayısının (2/27) ASA kullanan hastalardakinden (16/46) daha az olduğunu saptadıklarını bildirmişlerdir. 18 Yine aynı çalışmada, karotis arter stenozu progresyonu gözlenen hasta sayısının, silostazol kullananlarda silostazol kullanmayanlara oranla daha az saptandığı bildirilmektedir (p=0,03). 18 Bizim çalış-mamızın sonuçlarında da silostazol kullanan hastaların stenoz yüzdesindeki azalmanın (%48,5, p=0,000) ASA+pentoksifilin kullanan hastalardakinden (%30, p=0,004) oransal ve istatistiksel olarak anlamlı şekilde daha fazla olduğu saptanmıştır.…”

Section: Ica-stenozunclassified

“…18 Yine aynı çalışmada, karotis arter stenozu progresyonu gözlenen hasta sayısının, silostazol kullananlarda silostazol kullanmayanlara oranla daha az saptandığı bildirilmektedir (p=0,03). 18 Bizim çalış-mamızın sonuçlarında da silostazol kullanan hastaların stenoz yüzdesindeki azalmanın (%48,5, p=0,000) ASA+pentoksifilin kullanan hastalardakinden (%30, p=0,004) oransal ve istatistiksel olarak anlamlı şekilde daha fazla olduğu saptanmıştır.…”

Section: Ica-stenozunclassified

Comparison of the Effects of Acetylsalicylic Acid+Pentoxyphilline with Cilostazol Treatments in Carotid Artery Stenosis Patients

Yılmaz¹,

Günaydın²

2015

Turkiye Klinikleri J Cardiovasc Sci

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Ö ÖZ ZE ET T A Am ma aç ç: : İnme Amerika Birleşik Devletleri (ABD)'nde en sık ölüm nedenleri arasında üçüncü sırada olup, %80'i iskemik tiptedir. İskemik inmelerin de yaklaşık %30'u karotis arter stenozuna sekonderdir. Bu çalışmanın amacı, revaskülarizasyona uygun olmayan karotis arter stenozlu hastaların medikal tedavisinde kullanılan güncel ilaçların altı ay süreyle hastalığın prognozuna, karotis arter çapı, stenoz yüzdesi, intimal kalınlık, akım hızı, direnç artışı ve plak büyüklüğüne ve semptomatoloji üzerine etkilerinin ve bu etkilerin farklılıklarının araştırılmasıdır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışmaya revaskülarizasyona uygun olmayan karotis arter stenozlu toplam 40 hasta dâhil edildi. Hastalar öne-rilen medikal tedaviye göre gruplandırıldı (silostazol 2x100 mg veya asetilsalisilik asit 1x150 mg+pen-toksifilin 2x600 mg). Hastaların başlangıç parametreleri ve klinik durumları kayıt edildikten sonra önerilen medikal tedavinin altıncı ayındaki kontrol parametreleri ve klinik durumları da kayıt edildi. B Bu ul lg gu ul la ar r: : Medikal tedavinin altıncı ayındaki kontrollerde internal karotis arter akım hızı, stenoz yüzdesi, plak büyüklüğü ve intimal kalınlık parametrelerinde her iki grup da azalma saptandı. Silostazol grubundaki azalma miktarı aynı zamanda istatistiksel açıdan anlamlı olarak değerlendirildi. Kontrol internal karotis arter çapı her iki grup da artmış bulundu ve yine silostazol grubundaki çap artışı istatistiksel olarak daha anlamlı idi. Kontrol internal karotis arter direnç miktarı parametresi silostazol grubunda azalmış, asetilsalisilik asit+pentoksifilin grubunda ise artmış olarak saptandı. Bu çalışmada gözlenen kombinasyon tedavisi etkinliği, eks vivo çalışmaların sonuçlarından öngörülebi-lir ve yırtılma ile indüklenen platelet P-selektin ekspresyonu üzerine olan etkisi ile açıklanabilir. S So on nu uç ç: : Bu çalışmanın sonuçları bize, karotis arter stenozu medikal tedavisinde risk faktörlerinin tedavisi yanı sıra silostazol tedavisinin de etkili olabileceği yönünde bulgular göstermiştir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Karotis stenozu; silostazol; aspirin A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Stroke is the third common reason of mortality in USA. 80% of stroke cases is ischemic type and 30% of them is secondary to carotid artery stenosis. This study aims at searching the efficiency of actual medications used commonly in the treatment of carotid artery stenosis patients inappropriate for surgery for six months comparing prognosis, carotid artery diameter, percentage of stenosis, intimal thickness, flow velocity, increase in resistance, plaque diameter and impact on semptomatology. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : A total of 40 patients inappropriate for revascularization surgery were randomized for medical treatment either to receive cilostazol 2x100 mg or acetylsalicylic acid 1x150 mg+pentoxifylline 2x600 mg. Data of baseline and six month after treatment were recorded. R Re es su ul lt ...

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Cilostazol Prevents Progression of Asymptomatic Carotid Artery Stenosis in Patients with Contralateral Carotid Artery Stenting

Cited by 7 publications

References 59 publications

Meta-Analysis of Studies Evaluating the Effect of Cilostazol on Major Outcomes After Carotid Stenting

Meta-Analysis of Studies Evaluating the Effect of Cilostazol on Major Outcomes After Carotid Stenting

Effect of Cilostazol in Preventing Restenosis after Carotid Artery Stenting Using the Carotid Wallstent: A Multicenter Retrospective Study

Comparison of the Effects of Acetylsalicylic Acid+Pentoxyphilline with Cilostazol Treatments in Carotid Artery Stenosis Patients

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