Impact of cilostazol on angiographic restenosis after balloon angioplasty for infrapopliteal artery disease in patients with critical limb ischemia

Eur J Vasc Endovasc Surg. 2012 Dec;44(6):577-81. doi: 10.1016/j.ejvs.2012.09.020. Epub 2012 Oct 26.

Abstract

Objective: To investigate whether cilostazol reduces restenosis and revascularization after infrapopliteal angioplasty.

Design: This study was a retrospective analysis of a multicenter prospective registry.

Materials and methods: Between February and April 2011, 63 patients (68 limbs, 101 lesions) with critical limb ischemia (CLI) were enrolled. Of these, 32 were cilostazol treated and 31 were the non-cilostazol-treated group. Outcome measures were binary restenosis by angiogram, reocclusion, target lesion revascularization (TLR), limb salvage rate and complete wound healing at 3 months.

Result: Procedural success was obtained in all patients. The backgrounds and lesion characteristics of patients with isolated tibial artery disease and CLI did not differ significantly between the two groups. In a lesion-based analysis, binary restenosis and reocclusion were significantly lower in the cilostazol group than in the non-cilostazol group (56.8% vs. 86.0%; p = 0.015, 20.5% vs. 43.6%; p = 0.015, respectively). The TLR was also significantly lower in the cilostazol group (27.5% vs. 52.8%, p = 0.014). After adjustment for covariables, cilostazol was found to be associated with reduced angiographic restenosis, reocclusion and TLR rates in CLI patients at 3 months after infrapopliteal angioplasty. However, it remained unclear whether cilostazol was also associated with improved clinical outcomes.

Conclusion: Cilostazol may be associated with reduced restenosis, reocclusion and clinically driven TLR at 3 months after infrapopliteal angioplasty.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon* / adverse effects
  • Angioplasty, Balloon* / mortality
  • Cardiovascular Agents / therapeutic use*
  • Chi-Square Distribution
  • Cilostazol
  • Constriction, Pathologic
  • Female
  • Humans
  • Ischemia / diagnostic imaging
  • Ischemia / drug therapy
  • Ischemia / mortality
  • Ischemia / therapy*
  • Japan
  • Limb Salvage
  • Logistic Models
  • Male
  • Peripheral Arterial Disease / diagnostic imaging
  • Peripheral Arterial Disease / drug therapy
  • Peripheral Arterial Disease / mortality
  • Peripheral Arterial Disease / therapy*
  • Popliteal Artery / diagnostic imaging
  • Popliteal Artery / drug effects*
  • Radiography
  • Registries
  • Retrospective Studies
  • Secondary Prevention
  • Tetrazoles / therapeutic use*
  • Time Factors
  • Treatment Outcome
  • Wound Healing / drug effects

Substances

  • Cardiovascular Agents
  • Tetrazoles
  • Cilostazol