title: Cerebrovascular effects of cilostazol in patients with atherosclerotic disease.
abstract: BACKGROUND
  Cilostazol is a potent selective inhibitor of phosphodiesterase-3 of proven efficacy in intermittent claudication. It has antiplatelet effect and produces vasodilatation in several vascular territories. This drug has been approved in some countries for the prevention of recurrence of cerebral infarction. Limited data in patients with cerebral infarcts suggest improvement in cerebral blood flow. Dilatation of cerebral vessels with carbon-dioxide challenge can be assessed by transcranial Doppler technique. The percentage increase in blood flow velocity is called cerebral vasomotor reactivity (CVR).
  
  
  OBJECTIVE
  In this investigation we sought to measure CVR before and after oral administration of cilostazol.
  
  
  METHODS
  We studied patients with risk factors for atherosclerosis before they received cilostazol (100 mg twice daily) for intermittent claudication. CVR was assessed by measuring bilateral middle cerebral artery blood flow velocity during normoventilation and after 3 minutes of breathing 8% carbon dioxide. One average value was obtained from each patient. CVR was measured the day before cilostazol first dose, at 1 month, and 3 to 6 months later.
  
  
  RESULTS
  We examined 9 patients (8 men and 1 woman) aged 67.6 +/- 8.4 years. All patients had hypertension, 5 had diabetes, 4 were smokers, 5 had high cholesterol levels, and 4 had coronary artery disease. CVR was 54.4 +/- 14.4% at baseline, and increased to 64.2 +/- 18.6% after 1 month (P < .05) and to 67.1 +/- 13.3% at 3 to 6 months later (P < .01).
  
  
  CONCLUSIONS
  Our findings suggest that cilostazol increases CVR in patients with atherosclerotic disease.
authors: Department of Neurology, Institute for Neurological Research, FLENI, Buenos Aires, Argentina.
authors: Sebastián F
authors: SF
authors: Ameriso
authors: Roberto
authors: R
authors: Lagos
authors: Luis Mariano
authors: LM
authors: Ferreira
authors: Lucía
authors: L
authors: Fernández Cisneros
authors: Antonio Ricardo
authors: AR
authors: La Mura