title: Antiplatelet therapy in critical limb ischemia: update on clopidogrel and cilostazol.
abstract: Antiplatelet therapy is essential for critical limb ischemia (CLI) patients, both as primary prevention for ischemic events and as adjuvant pharmacotherapy in order to avoid acute or late thrombo-occlusive events and maintain patency following peripheral endovascular or open surgical limb-salvage revascularization procedures. According to currently updated international guidelines clopidogrel as monotherapy or as part of dual antiplatelet therapy is recommended in CLI patients, while recent evidence delineated the beneficial effect of cilostazol in patients undergoing peripheral endovascular angioplasty or stenting as its administration resulted in a decrease of restenosis and clinically-driven reinterventions, as well as in the enhancement of platelet inhibition. This review aims in discussing recent evidence on the topic of antiplatelet therapy in CLI patients, with a special focus on the use of clopidogrel and cilostazol.
authors.affiliation: Department of Interventional Radiology Patras University Hospital, Patras, Greece - stavspiliop@upatras.gr.
authors.forename: S
authors.initials: S
authors.lastname: Spiliopoulos
mesh_terms: D000077407:Cilostazol; D000077144:Clopidogrel; D003131:Combined Modality Therapy; D016638:Critical Illness; D004359:Drug Therapy, Combination; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D035002:Lower Extremity / Q000098:blood supply*; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors; D015607:Stents; D013777:Tetrazoles / Q000009:adverse effects / Q000627:therapeutic use*; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D000077144:Clopidogrel; D000077407:Cilostazol; D013988:Ticlopidine