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

Takayama, Katsutoshi; Taoka, Toshiaki; Nakagawa, Hiroyuki; Myouchin, Kaoru; Wada, Takeshi; Sakamoto, Masahiko; Furuichi, Kengo; Iwasaki, Shigeo; Kurokawa, Syuhei; Kichikawa, Kimihiko

doi:10.3174/ajnr.a3127

Cited by 23 publications

(24 citation statements)

References 25 publications

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“…Regarding major/minor bleeding, 3 of the studies 17,20,21 did not report any result and 2 studies 16,22 reported null bleeding events after CAS. Only one study 19 reported 7 bleedings overall (6 access site hematomas and 1 hemorrhage due to Regarding the revascularization rate post ISR, only 3 studies 18,19,22 reported a pooled rate of 33 endovascular treatments in 51 cases of ISR (65%) without stratifying the results according to antiplatelet treatment.…”

Section: Resultsmentioning

confidence: 99%

“…Regarding clinical events post CAS, data were adequate for comparison in only 5 trials 16,17,19,21,22 for 30-day outcomes and in 4 trials [17][18][19]21 for outcomes during the followup period. As no heterogeneity was identified, fixed-effect models were utilized.…”

Section: Resultsmentioning

confidence: 99%

“…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%

“…The basic characteristics of all included patients are presented in Table 2 Four studies [17][18][19]21 were identified to compare basic characteristics between patients treated with cilostazol and those not. The pooled subanalysis of these studies found the groups relatively similar except for dyslipidemia and the use of open cell stents (Table 3).…”

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%

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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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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…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%

Section: Resultsmentioning

confidence: 99%

Section: Study Selection and Outcomesmentioning

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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Update on Cilostazol: A Critical Review of Its Antithrombotic and Cardiovascular Actions and Its Clinical Applications

Manolis

Manolis²,

Melita

et al. 2021

The Journal of Clinical Pharma

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Cilostazol, a phosphodiesterase III inhibitor, has vasodilating and antiplatelet properties with a low rate of bleeding complications. It has been used over the past 25 years for improving intermittent claudication in patients with peripheral artery disease (PAD). Cilostazol also has demonstrated efficacy in patients undergoing percutaneous revascularization procedures for both PAD and coronary artery disease. In addition to its antithrombotic and vasodilating actions, cilostazol also inhibits vascular smooth muscle cell proliferation via phosphodiesterase III inhibition, thus mitigating restenosis. Accumulated evidence has shown that cilostazol, due to its "pleiotropic" effects, is a useful, albeit underutilized, agent for both coronary artery disease and PAD. It is also potentially useful after ischemic stroke and is an alternative in those who are allergic or intolerant to classical antithrombotic agents (eg, aspirin or clopidogrel). These issues are herein reviewed together with the pharmacology and pharmacodynamics of cilostazol. Large studies and meta-analyses are presented and evaluated. Current guidelines are also discussed, and the spectrum of cilostazol's actions and therapeutic applications are illustrated.

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Endovascular Management of Extracranial Carotid Disease

Ikeda¹,

Shaw²,

Sauvageau³

et al. 2015

PanVascular Medicine

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

Cited by 23 publications

References 25 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

Update on Cilostazol: A Critical Review of Its Antithrombotic and Cardiovascular Actions and Its Clinical Applications

Endovascular Management of Extracranial Carotid Disease

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