Cilostazol improves long-term patency after percutaneous transluminal angioplasty in hemodialysis patients with peripheral artery disease.
نویسندگان
چکیده
BACKGROUND AND OBJECTIVES Peripheral artery disease (PAD) is common in patients on hemodialysis (HD). Recently, cilostazol has been reported to reduce target lesion revascularization (TLR) after percutaneous transluminal angioplasty (PTA) for PAD in the general population. This study aimed to clarify the effects of cilostazol administration on long-term patency after PTA in HD patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Three-hundred seventy-two consecutive lesions in 193 HD patients successfully undergoing PTA were enrolled in the study and divided into two groups: patients receiving 100 mg cilostazol twice daily in conjunction with standard therapy (130 lesions in 71 patients) and those not administered cilostazol (242 lesions in 122 patients). Effects of cilostazol on preventing restenosis after PTA in these patients were investigated. RESULTS Kaplan-Meier analysis demonstrated the 5-yr patency rate was significantly higher in the cilostazol group than in the control group [52.4 versus 32.9%, hazard ratio (HR) 0.55; 95% confidence interval (CI) 0.39 to 0.77, P = 0.0005]. Cox multivariate analysis revealed that administration of cilostazol was an independent predictor of preventing restenosis (HR 0.56, 95% CI 0.36 to 0.87, P = 0.010). In 102 lesions matched after propensity score analysis, cilostazol had a beneficial effect on preventing restenosis (58.4 versus 34.7%, HR 0.47, 95% CI 0.30 to 0.75, P = 0.0017) and was an independent predictor of preventing restenosis (HR 0.50; 95% CI 0.26 to 0.87, P = 0.014) after multivariate Cox analysis. CONCLUSIONS Cilostazol administration improves long-term patency after PTA in HD patients with PAD.
منابع مشابه
Efficacy of percutaneous transluminal angioplasty in the management of chronic hemodialysis patients.
Percutaneous transluminal angioplasty (PTA) has gained wide acceptance as an effective technique for the dilatation of stenoses in the arterial tree. We evaluated the long-term results of vascular access in a group undergoing hemodialysis, in particular the effects of PTA. Twenty-four percutaneous procedures were performed on 18 patients. Detection was based on physical examination, flow rate m...
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ورودعنوان ژورنال:
- Clinical journal of the American Society of Nephrology : CJASN
دوره 3 4 شماره
صفحات -
تاریخ انتشار 2008