Cilostazol is associated with improved outcomes after peripheral endovascular interventions

Area of Science:

• Vascular Surgery
• Pharmacology
• Interventional Cardiology

Background:

• Cilostazol is frequently used as an adjunct therapy following peripheral vascular interventions.
• However, its effectiveness in improving patient outcomes after these procedures remains uncertain.

Purpose of the Study:

• To evaluate the efficacy of cilostazol as an adjunct to antiplatelet therapy after peripheral vascular interventions.
• This meta-analysis aimed to synthesize evidence from multiple studies to clarify cilostazol's role.

Main Methods:

• A systematic literature search was conducted across MEDLINE, Cochrane CENTRAL, and trial registries.
• Studies comparing cilostazol plus antiplatelet therapy versus antiplatelet therapy alone were included.
• Pooled risk/hazard ratios (HR) with random-effects models were used to analyze treatment effects.

Main Results:

• The meta-analysis included 2 randomized trials and 4 retrospective cohorts, totaling 1522 patients.
• Cilostazol use was associated with significantly decreased restenosis (RR, 0.71), improved amputation-free survival (HR, 0.63), and better limb salvage (HR, 0.42).
• Improved freedom from target lesion revascularization (RR, 1.36) was observed, with no significant impact on mortality.

Conclusions:

• Adding cilostazol to antiplatelet therapy after peripheral vascular interventions reduces the risk of restenosis, amputation, and target lesion revascularization.
• Cilostazol is a potentially beneficial medical adjunct for patients undergoing peripheral vascular interventions.
• Further research may be needed to confirm generalizability of these findings.