Our objective was to investigate the effect of cilostazol in acute therapy for small
vessel stroke patients. The neurologic deficits in some patients of small vessel brain
infarction will progress even if a patient takes immediate medical treatments including
aspirin or other antiplatelet drugs. In Japan, cilostazol, presenting not only the
antiplatelet effect but also the arteriole dilation, is used for treatment of ischemic
stroke. In this study, acute stroke patients with small vessel occlusion were treated
with cilostazol instead of aspirin in the conventional medication after 2010. Therefore,
patients between April 2007 and March 2009 were classified into the conventional group
(group-con, n = 220), and patients between April 2010 and March 2012 were classified
into the cilostazol group (group-cilo, n = 230). Enrolled patients were classified
into lacunar infarction (LI) and branch atheromatous disease. Progressing stroke was
defined as the increase of National Institutes of Health Stroke Scale score of 2 or
more within 48 hours. The clinical outcome was assessed by the modified Rankin Scale
(mRS) score at 1 month. As the result, the significant reduction in progressing stroke
was dominant in the LI of brainstem (P = .01). The length of hospital stay was significantly shorter in the group-cilo compared
with the group-con (18.6 and 21.2 days, P = .03). Moreover, mRS score at 1 month was significantly lower in the group-cilo
than the group-con (1.9 and 2.3, P = .03). In conclusion, cilostazol reduced the risk of early neurologic deterioration
of patients with small vessel brain infarction. It is eagerly desired to conduct a
large randomized control trial.
Key Words
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Article info
Publication history
Published online: February 10, 2014
Accepted:
November 27,
2013
Received in revised form:
November 20,
2013
Received:
October 15,
2013
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.11.023
Copyright
© 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.
