title: Efficacy of cilostazol after endovascular therapy for femoropopliteal artery disease in patients with intermittent claudication.
abstract: OBJECTIVE
  The purpose of this study was to investigate whether cilostazol reduces restenosis and revascularization after endovascular therapy (EVT) for femoropopliteal lesions.
  
  
  BACKGROUND
  Cilostazol improves walking distance in patients with intermittent claudication and reduces restenosis after coronary intervention, but its efficacy remains unclear after EVT for femoropopliteal disease.
  
  
  METHODS
  This study was performed as a multicenter, randomized, open-label clinical trial. Eighty patients (mean age 70.7 +/- 6.2 years, 84% men) with intermittent claudication due to a femoropopliteal lesion were randomly assigned to receive or not receive cilostazol in addition to aspirin. The primary end point was freedom from target vessel revascularization, and the secondary end points were the rate of restenosis and freedom from target lesion revascularization and major adverse cardiovascular events, defined as all-cause death, myocardial infarction, stroke, repeat revascularization, and leg amputation.
  
  
  RESULTS
  Clinical follow-up information was obtained in all patients. Patient, lesion, and procedural characteristics did not differ significantly between the 2 groups. Stenting was performed in 36 patients (cilostazol, 16; control, 20; p = 0.36). Freedom from target vessel revascularization at 2 years after EVT was significantly higher compared with the control group (84.6% vs. 62.2%, p = 0.04). The rate of restenosis was lower in the cilostazol group (43.6% vs. 70.3%, p = 0.02), and freedom from target lesion revascularization and major adverse cardiovascular events was higher in the cilostazol group (87.2% vs. 67.6%, p = 0.046, 76.8% vs. 45.6%, p = 0.006, respectively). There was no major bleeding in either group during follow-up period.
  
  
  CONCLUSIONS
  Cilostazol reduced restenosis and repeat revascularization after EVT in patients with intermittent claudication due to femoropopliteal disease.
authors.affiliation: Department of Cardiology, Kokura Memorial Hospital, Kitakyusyu, Japan.
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Soga
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Yokoi
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kawasaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nakashima
authors.forename: Masanori
authors.initials: M
authors.lastname: Tsurugida
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hikichi
authors.forename: Masakiyo
authors.initials: M
authors.lastname: Nobuyoshi
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon; D000077407:Cilostazol; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006083:Graft Occlusion, Vascular / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D007383:Intermittent Claudication / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery; D012086:Reoperation; D013777:Tetrazoles / Q000627:therapeutic use*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D013777:Tetrazoles; D014665:Vasodilator Agents; D000077407:Cilostazol