Comparison of the Effects of Acetylsalicylic Acid+Pentoxyphilline with Cilostazol Treatments in Carotid Artery Stenosis Patients

Abstract

Objective: Stroke is the third common reason of mortality in USA. 80% of stroke cases is ischemic type and 30% of them is secondary to carotid artery stenosis. This study aims at searching the efficiency of actual medications used commonly in the treatment of carotid artery stenosis patients inappropriate for surgery for six months comparing prognosis, carotid artery diameter, percentage of stenosis, intimal thickness, flow velocity, increase in resistance, plaque diameter and impact on semptomatology. Material and Methods: A total of 40 patients inappropriate for revascularization surgery were randomized for medical treatment either to receive cilostazol 2x100 mg or acetylsalicylic acid 1x150 mg+pentoxifylline 2x600 mg. Data of baseline and six month after treatment were recorded. Results: In six-month control, internal carotid artery Vmax, percentage stenosis, plaque diameter and intimal thickness decreased in both groups. Decrease in cilostazol group was significantly better than control group. Control internal carotid artery diameter increased in both groups, but it was significantly better in cilostazol group. Control internal carotid artery resistance index parameter decreased in cilostazol group but increased in acetylsalicylic acid group. This combination therapy can be predicted from the results of activity observed in the study of ex vivo studies and explained by the effect on platelet P-selectin expression induced by tearing. Conclusion: This study demonstrates that cilostazol treatment may be a good alternative with control of risk factors in the follow-up of carotid artery stenosis patients inappropriate for surgery.