title: Prevention of Femoropopliteal In-Stent Restenosis With Cilostazol: A Meta-Analysis.
abstract: Severe peripheral artery disease requires revascularization to relieve life-limiting ischemic symptoms. Postrevascularization in-stent restenosis continues to be a problem after femoropopliteal procedures. Our aim was to evaluate the use of cilostazol to prevent in-stent restenosis among patients with lower extremity arterial stenting. We performed a MEDLINE and EMBASE search and reviewed the abstracts and manuscripts following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The primary efficacy outcome was patency rate after stenting. The odds ratio estimates were pooled using the Mantel-Haenszel random-effects method. We identified 524 studies, and 20 articles were fully abstracted and 4 were included in the meta-analysis. The total number of patients included was 2434. Patients in the cilostazol group had better primary patency rates after endovascular stenting than those not taking cilostazol (odds ratio: 0.55; 95% confidence interval: 0.43-0.71). The use of cilostazol appears to prevent in-stent restenosis of high-risk patients.
authors.affiliation: Department of Internal Medicine, University of Oklahoma Health Sciences Center and Department of Veterans Affairs Medical Center, Oklahoma City, OK, USA.
authors.forename: Omer
authors.initials: O
authors.lastname: Iftikhar
authors.affiliation: Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.
authors.forename: Karla
authors.initials: K
authors.lastname: Oliveros
authors.affiliation: Vascular Medicine, Cardiovascular Institute, NorthShore University HealthSystem, Evanston, IL, USA.
authors.forename: Alfonso J
authors.initials: AJ
authors.lastname: Tafur
authors.affiliation: Cardiovascular Medicine Section, Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA ana-casanegra@ouhsc.edu.
authors.forename: Ana I
authors.initials: AI
authors.lastname: Casanegra
mesh_terms: D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000077407:Cilostazol; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D006801:Humans; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D065840:Protective Factors; D012008:Recurrence; D012307:Risk Factors; D015607:Stents; D013777:Tetrazoles / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency / Q000187:drug effects
chemical_list: D002317:Cardiovascular Agents; D013777:Tetrazoles; D000077407:Cilostazol
keywords: cilostazol; peripheral arterial disease; primary patency; stenosis; stent