| Impact of cilostazol after endovascular treatment for infrainguinal disease in patients with critical limb ischemia. | |
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MedLine Citation:
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PMID: 21872419 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Cilostazol reduces restenosis and repeat revascularization after endovascular therapy (EVT) in claudicant patients with femoropopliteal lesions. However, the efficacy of cilostazol in patients with critical limb ischemia (CLI) is unclear. Therefore, we investigated the effect of cilostazol on outcomes in patients with CLI. METHODS: From January 2004 to December 2009, 618 patients (30.8% women, 356 treated with cilostazol, 72.4 ± 7.3 years old) with CLI underwent EVT for de novo infrainguinal lesions. Their data were retrospectively analyzed. The primary outcome measure was amputation-free survival (AFS), The secondary outcome measures were overall survival, limb salvage, freedom from repeat revascularization, and freedom from surgical conversion. Mean follow-up was 21 ± 14 months. RESULTS: AFS and the limb salvage rate at 5 years were significantly higher in the cilostazol-treated group (47.7% vs 32.7%, P < .01; 86.6% vs 75.3%, P < .01; respectively). However, overall survival and freedom from repeat revascularization at 5 years did not differ significantly between the two groups (43.9% vs 46.0%, P = .24; 39.9% vs 31.8%, P = .21, respectively). Freedom from surgical conversion at 5 years was significantly higher in the cilostazol-treated group (91.0% vs 81.2%, P < .01). After correcting all end points with baseline variables, cilostazol was effective for prevention of AFS (hazard ratio [HR], 0.67; 95% confidential interval [CI], 0.49-0.91; adjusted P = .01) and improvement of limb salvage rate (HR, 0.42; 95% CI, 0.25-0.69; adjusted P < .01). There was no significant difference in overall survival, repeat revascularization, and surgical conversion between the groups. CONCLUSIONS: Cilostazol may improve AFS and limb salvage rate after EVT for infrainguinal disease in patients with CLI. |
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Authors:
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Yoshimitsu Soga; Osamu Iida; Keisuke Hirano; Kenji Suzuki; Daizo Kawasaki; Yusuke Miyashita; Taketsugu Tsuchiya; Masakiyo Nobuyoshi |
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Publication Detail:
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Type: Journal Article; Multicenter Study Date: 2011-08-27 |
Journal Detail:
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Title: Journal of vascular surgery Volume: 54 ISSN: 1097-6809 ISO Abbreviation: J. Vasc. Surg. Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-05 Completed Date: 2012-04-03 Revised Date: 2012-10-03 |
Medline Journal Info:
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Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1659-67 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. sogacchy@yahoo.co.jp |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Angioplasty, Balloon* Arterial Occlusive Diseases / mortality, pathology, therapy* Female Femoral Artery Fibrinolytic Agents / therapeutic use* Humans Ischemia / mortality, pathology, therapy* Limb Salvage Lower Extremity / blood supply* Male Middle Aged Popliteal Artery Postoperative Care Retrospective Studies Tetrazoles / therapeutic use* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; 0/Tetrazoles; 73963-72-1/cilostazol |
| Comments/Corrections | |
Comment In:
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J Vasc Surg. 2012 Mar;55(3):891; author reply 891-2
[PMID:
22370033
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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