Effect of cilostazol in the treatment of acute ischemic stroke in the lenticulostriate artery territory.

Ryushi Kondo, Yasushi Matsumoto, Eisuke Furui, Ryo Itabashi, Shoichiro Sato, Yukako Yazawa, Hiroaki Shimizu, Satoru Fujiwara, Akira Takahashi, Teiji Tominaga

Index: Eur. Neurol. 69(2) , 122-8, (2013)

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Abstract

Cilostazol, an inhibitor of phosphodiesterase 3, has various pleiotropic effects besides its antiplatelet activity. This study examined the efficacy of cilostazol for the treatment of acute perforating artery infarction.In this prospective, randomized, open-label, blinded-end point trial, 100 patients with cerebral infarction in the territory of the lenticulostriate arteries were enrolled within 48 h of onset. Patients were randomly treated with both cilostazol and ozagrel for 14 days (n = 50, cilostazol group) or ozagrel alone for 14 days (n = 50, control group). The primary end point was the proportion of favorable outcomes 30 days after randomization as defined by a modified Rankin Scale (mRS) score of 0-2. Secondary end points included the incidence of neurological deterioration (an increase of ≥ 2 on the National Institutes of Health Stroke Scale within 7 days).Favorable outcomes (mRS scores 0-2) were similar in both groups (81.3 and 82.0% in the cilostazol and control groups, respectively). The incidence of neurological deterioration was lower in the cilostazol group than the control group (12.5 and 16.0%, respectively) with a 21.9% relative risk reduction, although the difference was not statistically significant.Cilostazol did not prevent the neurological deterioration of perforating artery infarction.Copyright © 2012 S. Karger AG, Basel.