Cilostazol for peripheral arterial disease - a position paper from the Italian Society for Angiology and Vascular Medicine.
Romeo MartiniWalter AgenoCorrado AmatoElisabetta FavarettoAngelo PorfidiaAdriana VisonàPublished in: VASA. Zeitschrift fur Gefasskrankheiten (2024)
Cilostazol is a quinolinone-derivative selective phosphodiesterase inhibitor and is a platelet-aggregation inhibitor and arterial vasodilator for the symptomatic treatment of intermittent claudication (IC). Cilostazol has been shown to improve walking distance for patients with moderate to severe disabling intermittent claudication who do not respond to exercise therapy and who are not candidates for vascular surgical or endovascular procedures. Several studies evaluated the pharmacological effects of cilostazol for restenosis prevention and indicated a possible effect on re-endothelialization mediated by hepatocyte growth factor and endothelial precursor cells, as well as inhibiting smooth muscle cell proliferation and leukocyte adhesion to endothelium, thereby exerting an anti-inflammatory effect. These effects may suggest a potential effectiveness of cilostazol in preventing restenosis and promoting the long-term outcome of revascularization interventions. This review aimed to point out the role of cilostazol in treating patients with peripheral arterial disease, particularly with IC, and to explore its possible role in restenosis after lower limb revascularization.
Keyphrases
- lower limb
- growth factor
- high intensity
- smooth muscle
- cell proliferation
- randomized controlled trial
- anti inflammatory
- physical activity
- percutaneous coronary intervention
- systematic review
- nitric oxide
- signaling pathway
- escherichia coli
- risk assessment
- stem cells
- coronary artery disease
- pseudomonas aeruginosa
- drug induced
- liver injury
- oxidative stress
- biofilm formation
- staphylococcus aureus
- aortic dissection