Lege Artis Medicinae

[Mechanism of action and role of cilostazol in treatment of peripheral arterial disease]

KOLTAI Katalin, BIRÓ Katalin, KOVÁCS Dávid, CSISZÁR Beáta, TÓTH Kálmán, KÉSMÁRKY Gábor

JUNE 01, 2015

Lege Artis Medicinae - 2015;25(04-05)

[Intermittent claudication is a typical symptom of lower extremity arterial disease. Cilostazol is a reversible, selective phosphodiesterase-3 inhibitor which has antiplatelet, antithrombotic and vasodilator effects. It is indicated to improve maximal and pain-free walking distance in patients with intermittent claudication in the absence of rest pain or peripheral tissue necrosis. It can be beneficial in diabetic patiens with intermittent claudication, as it has been proved to prevent the development of foot ulcers. In combination with acetyl-salicylic acid it may help maintain stent patency after endovascular intervention and stent implantation. Cilostazol is contraindicated in heart failure. With cilostazol, a clinically proven effective drug has become available in the treatment of intermittent claudication which could improve walking and life quality of patients.]

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[INTRODUCTION - Cilostazol is available in Hungary for patients with peripheral atherosclerotic disease (PAD) since June 2014. PATIENTS AND METHOD - In this prospective clinical data collection 68 patients were investigated with PAD-CI, treated with cilostazol. All patients were in stage of Fontaine II at the beginning of the study. Every patient has been able to control for at least three months. Two investigated groups have been treated with cilostazol. Group I: patients operated on lower extremity with femoropopliteal bypass earlier of this study and group II: patients with PAD but no arterial reconstruction in their medical record. Every patient got 100 mg cilostazol twice a day. Anticholesterol, platelet inhibition treatment have been continued in every case. No patients have taken pentoxifyllin. The end points of the data collection were the walking distance alteration (elongation) expressed in meter and the changing of the complaints of claudication intermittent. 61 patients have tolerated cilostazol treatment without side effects. Seven patients out of 68 have not tolerated it, that is why the treatment was suspended. Thirty-four out of 61 patients’ walking distance was elongated with at least 50 meters. 21 patients’ claudication improved between 50 to 100 meters and 12 patients’ walking distance improved more than 100 meters. CONCLUSION - The cilostazol presumably will be an unavoidable factor in the effective treatment of peripheral atherosclerotic disease. ]