Efficacy of cilostazol in prevention of bradycardia during carotid artery stenting

Daizo Ishii, Tetsu Satow, Kenichi Murao, Kunihiro Nishimura, Koji Iihara

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background Hypotension and bradycardia are known to occur frequently in carotid artery stenting (CAS), which may lead to postprocedural complications. The purpose of this retrospective study was to assess the efficacy of cilostazol, a phosphodiesterase 3 inhibitor, for preventing bradycardia and hypotension in the periprocedural period. Methods The study population comprised 53 patients (54 lesions) with carotid artery stenosis who underwent CAS at our institution between 2004 and 2008. The patients were categorized by the use (group C, n = 26) or nonuse of cilostazol (group N, n = 28). The incidences of intraprocedural and postprocedural hypotension and bradycardia in each group were statistically assessed. Results Intraprocedural hypotension and bradycardia occurred in 9 cases (34.6%) and 4 cases (15.3%) in group C and in 5 cases (17.9%) and 15 cases (53.6%) in group N, respectively. Postprocedural hypotension and bradycardia occurred in 4 cases (15.4%) and 0 cases in group C and in 1 case (3.6%) and 3 cases (10.7%) in group N, respectively. The incidence of intraprocedural bradycardia (IBc) was significantly lower in group C (P =.0035). Logistic regression analysis revealed that the use of cilostazol decreased the risk of IBc 99.5% (odds ratio [OR] =.01, 95% confidence interval [CI]: 5.46 × 10-6 to.04, P =.001) and distance from carotid bifurcation to maximum stenotic lesion was independently associated with IBc (OR =.46, 95% CI:.29-.74, P =.001). Conclusion Use of cilostazol was associated with a lower incidence of IBc. Cilostazol may be a useful drug for the prevention of this complication.

Original languageEnglish
Pages (from-to)662-666
Number of pages5
JournalJournal of Stroke and Cerebrovascular Diseases
Volume23
Issue number4
DOIs
Publication statusPublished - Jan 1 2014
Externally publishedYes

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Bradycardia
Carotid Arteries
Hypotension
Incidence
Phosphodiesterase 3 Inhibitors
Odds Ratio
Confidence Intervals
cilostazol
Carotid Stenosis
Retrospective Studies
Logistic Models
Regression Analysis
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Efficacy of cilostazol in prevention of bradycardia during carotid artery stenting. / Ishii, Daizo; Satow, Tetsu; Murao, Kenichi; Nishimura, Kunihiro; Iihara, Koji.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 23, No. 4, 01.01.2014, p. 662-666.

Research output: Contribution to journalArticle

Ishii, Daizo ; Satow, Tetsu ; Murao, Kenichi ; Nishimura, Kunihiro ; Iihara, Koji. / Efficacy of cilostazol in prevention of bradycardia during carotid artery stenting. In: Journal of Stroke and Cerebrovascular Diseases. 2014 ; Vol. 23, No. 4. pp. 662-666.
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abstract = "Background Hypotension and bradycardia are known to occur frequently in carotid artery stenting (CAS), which may lead to postprocedural complications. The purpose of this retrospective study was to assess the efficacy of cilostazol, a phosphodiesterase 3 inhibitor, for preventing bradycardia and hypotension in the periprocedural period. Methods The study population comprised 53 patients (54 lesions) with carotid artery stenosis who underwent CAS at our institution between 2004 and 2008. The patients were categorized by the use (group C, n = 26) or nonuse of cilostazol (group N, n = 28). The incidences of intraprocedural and postprocedural hypotension and bradycardia in each group were statistically assessed. Results Intraprocedural hypotension and bradycardia occurred in 9 cases (34.6{\%}) and 4 cases (15.3{\%}) in group C and in 5 cases (17.9{\%}) and 15 cases (53.6{\%}) in group N, respectively. Postprocedural hypotension and bradycardia occurred in 4 cases (15.4{\%}) and 0 cases in group C and in 1 case (3.6{\%}) and 3 cases (10.7{\%}) in group N, respectively. The incidence of intraprocedural bradycardia (IBc) was significantly lower in group C (P =.0035). Logistic regression analysis revealed that the use of cilostazol decreased the risk of IBc 99.5{\%} (odds ratio [OR] =.01, 95{\%} confidence interval [CI]: 5.46 × 10-6 to.04, P =.001) and distance from carotid bifurcation to maximum stenotic lesion was independently associated with IBc (OR =.46, 95{\%} CI:.29-.74, P =.001). Conclusion Use of cilostazol was associated with a lower incidence of IBc. Cilostazol may be a useful drug for the prevention of this complication.",
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AU - Ishii, Daizo

AU - Satow, Tetsu

AU - Murao, Kenichi

AU - Nishimura, Kunihiro

AU - Iihara, Koji

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N2 - Background Hypotension and bradycardia are known to occur frequently in carotid artery stenting (CAS), which may lead to postprocedural complications. The purpose of this retrospective study was to assess the efficacy of cilostazol, a phosphodiesterase 3 inhibitor, for preventing bradycardia and hypotension in the periprocedural period. Methods The study population comprised 53 patients (54 lesions) with carotid artery stenosis who underwent CAS at our institution between 2004 and 2008. The patients were categorized by the use (group C, n = 26) or nonuse of cilostazol (group N, n = 28). The incidences of intraprocedural and postprocedural hypotension and bradycardia in each group were statistically assessed. Results Intraprocedural hypotension and bradycardia occurred in 9 cases (34.6%) and 4 cases (15.3%) in group C and in 5 cases (17.9%) and 15 cases (53.6%) in group N, respectively. Postprocedural hypotension and bradycardia occurred in 4 cases (15.4%) and 0 cases in group C and in 1 case (3.6%) and 3 cases (10.7%) in group N, respectively. The incidence of intraprocedural bradycardia (IBc) was significantly lower in group C (P =.0035). Logistic regression analysis revealed that the use of cilostazol decreased the risk of IBc 99.5% (odds ratio [OR] =.01, 95% confidence interval [CI]: 5.46 × 10-6 to.04, P =.001) and distance from carotid bifurcation to maximum stenotic lesion was independently associated with IBc (OR =.46, 95% CI:.29-.74, P =.001). Conclusion Use of cilostazol was associated with a lower incidence of IBc. Cilostazol may be a useful drug for the prevention of this complication.

AB - Background Hypotension and bradycardia are known to occur frequently in carotid artery stenting (CAS), which may lead to postprocedural complications. The purpose of this retrospective study was to assess the efficacy of cilostazol, a phosphodiesterase 3 inhibitor, for preventing bradycardia and hypotension in the periprocedural period. Methods The study population comprised 53 patients (54 lesions) with carotid artery stenosis who underwent CAS at our institution between 2004 and 2008. The patients were categorized by the use (group C, n = 26) or nonuse of cilostazol (group N, n = 28). The incidences of intraprocedural and postprocedural hypotension and bradycardia in each group were statistically assessed. Results Intraprocedural hypotension and bradycardia occurred in 9 cases (34.6%) and 4 cases (15.3%) in group C and in 5 cases (17.9%) and 15 cases (53.6%) in group N, respectively. Postprocedural hypotension and bradycardia occurred in 4 cases (15.4%) and 0 cases in group C and in 1 case (3.6%) and 3 cases (10.7%) in group N, respectively. The incidence of intraprocedural bradycardia (IBc) was significantly lower in group C (P =.0035). Logistic regression analysis revealed that the use of cilostazol decreased the risk of IBc 99.5% (odds ratio [OR] =.01, 95% confidence interval [CI]: 5.46 × 10-6 to.04, P =.001) and distance from carotid bifurcation to maximum stenotic lesion was independently associated with IBc (OR =.46, 95% CI:.29-.74, P =.001). Conclusion Use of cilostazol was associated with a lower incidence of IBc. Cilostazol may be a useful drug for the prevention of this complication.

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