Cilostazol improved amputation-free survival and ulcer healing in patients with critical limb ischemia who underwent endovascular or surgical revascularization, researchers reported.
The researchers conducted a retrospective, single-center cohort study to determine predictors of ulcer healing time and amputation-free survival in patients with Rutherford class 5 CLI who underwent infrainguinal arterial revascularization.
Of the 129 limbs analyzed, 69 underwent endovascular revascularization and 60 were revascularized surgically. Mean follow-up was 21.5 months.
Complete ulcer healing was achieved in 74% of limbs, with a median time to healing of 90 days, Tadashi Furuyama, MD, from the department of surgery and science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan, and colleague wrote.
When the researchers conducted a multivariable analysis, they determined the following to be predictors of poor prognosis for ulcer healing: no cilostazol use (P = .0114), white blood cell count greater than 10,000 (P = .0185), major defect after debridement (P = .0215) and endovascular therapy (P = .0308).
Poor prognostic factors for amputation-free survival were ischemic heart disease (P < .0001), albumin level less than 3 g/dL (P = .0016), no cilostazol use (P = .0078) and major defect after debridement (P = .0208), according to the researchers.
“In patients with Rutherford class 5 CLI, no cilostazol use after arterial revascularization is impaired in ulcer healing within 90 days,” Furuyama and colleagues wrote. “Additionally, cilostazol use improves secondary patency and [amputation-free survival] after [endovascular therapy] and surgical procedures. Cilostazol use may be an optimal medical treatment for CLI.” – by Erik Swain
Disclosures: The authors report no relevant financial disclosures.