論文

国際誌
2012年4月

Periprocedural cilostazol treatment and restenosis after carotid artery stenting: the Retrospective Study of In-Stent Restenosis after Carotid Artery Stenting (ReSISteR-CAS).

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
  • Hiroshi Yamagami
  • Nobuyuki Sakai
  • Yuji Matsumaru
  • Chiaki Sakai
  • Yutaka Kai
  • Kenji Sugiu
  • Toshiyuki Fujinaka
  • Yasushi Matsumoto
  • Shigeru Miyachi
  • Shinichi Yoshimura
  • Toshio Hyogo
  • Naoya Kuwayama
  • Akio Hyodo
  • 全て表示

21
3
開始ページ
193
終了ページ
9
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.jstrokecerebrovasdis.2010.06.007

Restenosis after carotid artery stenting (CAS) is a critical issue. Cilostazol can reduce restenosis after interventions in coronary or femoropopliteal arteries. We investigated whether periprocedural cilostazol treatment was related to the incidence of in-stent restenosis (ISR) or target vessel revascularization (TVR) after CAS. The study group comprised 553 of 580 patients who underwent CAS between April 2003 and August 2006 and were followed for 30 months after the procedure. ISR was defined as stenosis of at least 50% detected on angiography or ultrasonography. TVR was defined as revascularization of the treated carotid artery. During CAS, 207 patients (37.4%) were treated with cilostazol. Over 30 months, ISR occurred in 23 patients (4.2%), TVR occurred in 16 patients (2.9%), and either ISR or TVR occurred in 25 patients (4.5%). The incidence of ISR or TVR was significantly lower in the cilostazol-treated group than in the untreated group (1.4% vs 6.4%; log-rank P = .006). In a multivariate analysis, cilostazol treatment (hazard ratio [HR], 0.28; 95% confidence interval [CI], 0.08-0.95; P = .041) and stent diameter (HR, 0.73/1-mm increase; 95% CI, 0.54-0.99; P = .044) were independent factors for the occurrence of ISR or TVR. The incidence of a composite of events, including thromboembolism, hemorrhage, death, and TVR, tended to be lower in the cilostazol-treated group than in the untreated group (15.0% vs 19.9%; log-rank P = .17). Periprocedural cilostazol treatment was associated with lower rates of ISR and retreatment after CAS. A prospective randomized controlled trial is needed to clarify the effect of cilostazol on ISR after CAS.

リンク情報
DOI
https://doi.org/10.1016/j.jstrokecerebrovasdis.2010.06.007
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/20851621
ID情報
  • DOI : 10.1016/j.jstrokecerebrovasdis.2010.06.007
  • PubMed ID : 20851621

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