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Published on: September 22, 2020
Antiplatelet therapy in critical limb ischemia: update on clopidogrel and cilostazol
1Department of Interventional Radiology Patras University Hospital, Patras, Greece - stavspiliop@upatras.gr.
Insights
Antiplatelet therapy, including clopidogrel and cilostazol, is crucial for critical limb ischemia (CLI) patients. These treatments help prevent ischemic events and maintain blood vessel patency after revascularization procedures.
Area of Science:
- Vascular Medicine
- Pharmacology
- Cardiovascular Research
Background:
- Critical limb ischemia (CLI) necessitates antiplatelet therapy for preventing ischemic events.
- Antiplatelet agents are vital for maintaining patency after revascularization in CLI patients.
Purpose of the Study:
- To review current evidence on antiplatelet therapy in critical limb ischemia.
- To focus on the roles of clopidogrel and cilostazol in managing CLI.
Main Methods:
- Review of recent scientific literature and clinical guidelines.
- Analysis of studies evaluating clopidogrel and cilostazol in CLI patients.
Main Results:
- Clopidogrel monotherapy or dual therapy is recommended for CLI.
- Cilostazol reduces restenosis and reinterventions after peripheral angioplasty/stenting.
- Cilostazol enhances platelet inhibition in CLI patients.
Conclusions:
- Antiplatelet therapy is a cornerstone in managing critical limb ischemia.
- Clopidogrel and cilostazol demonstrate significant benefits in CLI treatment and prevention of thrombo-occlusive events.
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.
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