Comparison of cilostazol with warfarin as antithrombotic therapy after femoro-popliteal bypass surgery using an ePTFE graft.
BACKGROUND
Cilostazol (6-[4-(1-cyclohexyl-1H-tetrazol-5-yl)butoxy]-3,4- dihydro-2(1H)-quinolinone) is a new antiplatelet agent with a vasodilating action. The purpose of this study was comparison of cilostazol with warfarin as antithrombotic therapy after femoro-popliteal bypass surgery using an expanded polytetrafluorethylene (ePTFE) graft.


METHODS
This report is a retrospective study and the patients were followed up for five years.


METHODS
Outpatients of university hospital.


METHODS
Sixteen arteriosclerosis obliterans patients, who were diagnosed as having only superficial femoral artery stenosis or occlusion, underwent femoro-popliteal (above the knee) bypass using an ePTFE graft 6 mm in diameter. Cilostazol (150-200 mg/day) was administered to 6 cases (9 bypasses), and warfarin (prothrombin time was controlled to 15-25%.) was administered to 10 cases (14 bypasses).


RESULTS
No clinically characteristic differences were found between the two groups. The cumulative 1-, 3-, and 5-year primary and secondary graft patency rates were 69% and 80%, 69% and 80%, and, 69% and 80% in the cilostazol group, vs 61% and 91%, 51% and 91%, and, 51% and 91% in the warfarin group, respectively. These differences were not significant (p < 0.05). No hemorrhage complications were observed in the cilostazol group. The management of cilostazol administration was safe and simple.


CONCLUSIONS
Although the number of cases was small in this study, cilostazol was considered to be as effective as warfarin and suitable for the postoperative antithrombotic therapy after the ePTFE bypass surgery.
Ohtake
H
H
Department of Surgery (I), Kanazawa University School of Medicine, Japan.
Urayama
H
H
Kimura
K
K
Yokoi
K
K
Tsunezuka
Y
Y
Kawakami
T
T
Kawasuji
M
M
Watanabe
Y
Y
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D001157:Arterial Occlusive Diseases / Q000601:surgery; D001162:Arteriosclerosis Obliterans / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011095:Polyethylenes; D011150:Popliteal Artery / Q000601:surgery*; D011182:Postoperative Care; D012189:Retrospective Studies; D013777:Tetrazoles / Q000627:therapeutic use*; D014859:Warfarin / Q000627:therapeutic use*
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D011095:Polyethylenes; D013777:Tetrazoles; D014859:Warfarin