Abstract：
OBJECTIVE: Restenosis and late occlusion remain a significant problem for endovascular treatment of peripheral artery disease. This meta-analysis aims to evaluate the effect of cilostazol on late outcomes after endovascular repair of occlusive femoropopliteal disease.
METHODS: A systematic literature review was conducted conforming to established criteria to identify articles published up to September 2023 evaluating late outcomes after endovascular treatment for atherosclerotic femoropopliteal disease. Eligible studies should compare outcomes between patients treated with cilostazol and patients not treated with cilostazol. Both prospective and retrospective studies were eligible. Late outcomes included primary patency (PP), restenosis, target lesion revascularization (TLR), and major amputation during follow-up.
RESULTS: Overall, 10 clinical studies were identified for analysis including 4721 patients (1831 with cilostazol vs 2890 without cilostazol) that were treated for 5703 lesions (2235 with cilostazol vs 3468 without cilostazol). All studies were performed in Japan. Mean follow-up was 24.1 ± 12.5 months. Cilostazol was associated with a lower risk for restenosis (pooled odds ratio [OR], 0.503; 95% confidence interval [CI], 0.383-0.660; P < .0001). However, no association was found between cilostazol and TLR (pooled OR, 0.918; 95% CI, 0.300-2.812; P = .881) as well as major amputation (pooled OR, 1.512; 95% CI, 0.734-3.116; P = .263). Regarding primary patency, cilostazol was associated with a higher 12-month PP (OR, 3.047; 95% CI, 1.168-7.946; P = .023), and a higher 36-month PP (OR, 1.616; 95% CI, 1.412-1.850; P < .0001). No association was found between cilostazol and mortality during follow-up (pooled OR, .755; 95% CI, 0.293-1.946; P = .561).
CONCLUSIONS: Cilostazol seems to have a positive effect on 1- to 3-year PP and restenosis rates among patients treated endovascularly for atherosclerotic femoropopliteal disease. A positive effect on TLR and amputation risk was not verified in this review.
METHODS: A systematic literature review was conducted conforming to established criteria to identify articles published up to September 2023 evaluating late outcomes after endovascular treatment for atherosclerotic femoropopliteal disease. Eligible studies should compare outcomes between patients treated with cilostazol and patients not treated with cilostazol. Both prospective and retrospective studies were eligible. Late outcomes included primary patency (PP), restenosis, target lesion revascularization (TLR), and major amputation during follow-up.
RESULTS: Overall, 10 clinical studies were identified for analysis including 4721 patients (1831 with cilostazol vs 2890 without cilostazol) that were treated for 5703 lesions (2235 with cilostazol vs 3468 without cilostazol). All studies were performed in Japan. Mean follow-up was 24.1 ± 12.5 months. Cilostazol was associated with a lower risk for restenosis (pooled odds ratio [OR], 0.503; 95% confidence interval [CI], 0.383-0.660; P < .0001). However, no association was found between cilostazol and TLR (pooled OR, 0.918; 95% CI, 0.300-2.812; P = .881) as well as major amputation (pooled OR, 1.512; 95% CI, 0.734-3.116; P = .263). Regarding primary patency, cilostazol was associated with a higher 12-month PP (OR, 3.047; 95% CI, 1.168-7.946; P = .023), and a higher 36-month PP (OR, 1.616; 95% CI, 1.412-1.850; P < .0001). No association was found between cilostazol and mortality during follow-up (pooled OR, .755; 95% CI, 0.293-1.946; P = .561).
CONCLUSIONS: Cilostazol seems to have a positive effect on 1- to 3-year PP and restenosis rates among patients treated endovascularly for atherosclerotic femoropopliteal disease. A positive effect on TLR and amputation risk was not verified in this review.
摘要：
背景：再狭窄和晚期闭塞仍然是外周动脉疾病血管内治疗的重要问题。这项荟萃分析旨在评估西洛他唑对闭塞性股pop疾病血管内修复术后晚期结局的影响。
方法：根据既定标准进行了系统文献综述，以确定截至2023年9月发表的评价动脉粥样硬化性股pop疾病血管内治疗后晚期结局的文章。符合条件的研究应比较接受西洛他唑治疗的患者和未接受西洛他唑治疗的患者的预后。前瞻性和回顾性研究均符合条件。晚期结局包括原发性通畅性（PP），再狭窄,随访期间靶病变血运重建（TLR）和大截肢。
结果：总体而言，确定了10项临床研究进行分析，其中包括4,721例患者（1,831例使用西洛他唑与2,890例不使用西洛他唑），治疗了5,703例病变（2,235例使用西洛他唑与3,468例不使用西洛他唑）。所有研究均在日本进行。平均随访时间为24.1+/-12.5个月。西洛他唑与较低的再狭窄风险相关（合并OR=.503；95%CI[.383-.660]；P<.0001）。然而,西洛他唑与TLR(合并OR=.918;95%CI[.300-2.812];P=.881)以及大截肢(合并OR=1.512;95%CI[.734-3.116];P=.263)之间未发现关联.关于初级通畅，西洛他唑与较高的12个月PP相关(OR=3.047;95%CI[1.168-7.946];P=0.023),36个月PP较高（OR=1.616；95%CI[1.412-1.850]；P<0.0001）。未发现西洛他唑与随访期间死亡率之间存在关联（合并OR=.755；95%CI[.293-1.946]；P=.561）。
结论：西洛他唑似乎对动脉粥样硬化股pop疾病血管内治疗患者的1-3年PP和再狭窄率有积极影响。在这篇综述中没有证实对TLR和截肢风险的积极影响。
方法：根据既定标准进行了系统文献综述，以确定截至2023年9月发表的评价动脉粥样硬化性股pop疾病血管内治疗后晚期结局的文章。符合条件的研究应比较接受西洛他唑治疗的患者和未接受西洛他唑治疗的患者的预后。前瞻性和回顾性研究均符合条件。晚期结局包括原发性通畅性（PP），再狭窄,随访期间靶病变血运重建（TLR）和大截肢。
结果：总体而言，确定了10项临床研究进行分析，其中包括4,721例患者（1,831例使用西洛他唑与2,890例不使用西洛他唑），治疗了5,703例病变（2,235例使用西洛他唑与3,468例不使用西洛他唑）。所有研究均在日本进行。平均随访时间为24.1+/-12.5个月。西洛他唑与较低的再狭窄风险相关（合并OR=.503；95%CI[.383-.660]；P<.0001）。然而,西洛他唑与TLR(合并OR=.918;95%CI[.300-2.812];P=.881)以及大截肢(合并OR=1.512;95%CI[.734-3.116];P=.263)之间未发现关联.关于初级通畅，西洛他唑与较高的12个月PP相关(OR=3.047;95%CI[1.168-7.946];P=0.023),36个月PP较高（OR=1.616；95%CI[1.412-1.850]；P<0.0001）。未发现西洛他唑与随访期间死亡率之间存在关联（合并OR=.755；95%CI[.293-1.946]；P=.561）。
结论：西洛他唑似乎对动脉粥样硬化股pop疾病血管内治疗患者的1-3年PP和再狭窄率有积极影响。在这篇综述中没有证实对TLR和截肢风险的积极影响。
