Prevention of Femoropopliteal In-Stent Restenosis With Cilostazol: A Meta-Analysis

Angiology. 2016 Jul;67(6):549-55. doi: 10.1177/0003319715604768. Epub 2015 Sep 21.


Severe peripheral artery disease requires revascularization to relieve life-limiting ischemic symptoms. Postrevascularization in-stent restenosis continues to be a problem after femoropopliteal procedures. Our aim was to evaluate the use of cilostazol to prevent in-stent restenosis among patients with lower extremity arterial stenting. We performed a MEDLINE and EMBASE search and reviewed the abstracts and manuscripts following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The primary efficacy outcome was patency rate after stenting. The odds ratio estimates were pooled using the Mantel-Haenszel random-effects method. We identified 524 studies, and 20 articles were fully abstracted and 4 were included in the meta-analysis. The total number of patients included was 2434. Patients in the cilostazol group had better primary patency rates after endovascular stenting than those not taking cilostazol (odds ratio: 0.55; 95% confidence interval: 0.43-0.71). The use of cilostazol appears to prevent in-stent restenosis of high-risk patients.

Keywords: cilostazol; peripheral arterial disease; primary patency; stenosis; stent.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Cardiovascular Agents / adverse effects
  • Cardiovascular Agents / therapeutic use*
  • Cilostazol
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Femoral Artery / diagnostic imaging
  • Femoral Artery / drug effects*
  • Femoral Artery / physiopathology
  • Humans
  • Odds Ratio
  • Peripheral Arterial Disease / diagnostic imaging
  • Peripheral Arterial Disease / physiopathology
  • Peripheral Arterial Disease / therapy*
  • Popliteal Artery / diagnostic imaging
  • Popliteal Artery / drug effects*
  • Popliteal Artery / physiopathology
  • Protective Factors
  • Recurrence
  • Risk Factors
  • Stents*
  • Tetrazoles / adverse effects
  • Tetrazoles / therapeutic use*
  • Time Factors
  • Treatment Outcome
  • Vascular Patency / drug effects


  • Cardiovascular Agents
  • Tetrazoles
  • Cilostazol