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Prospects of using cilostazol in combined treatment of patients with obliterating atherosclerosis of lower limb arteries

Despite intensive study of pathophysiology, of molecular and cell mechanisms of progression of atherosclerosis, development and introduction of a wide range of new conservative and surgical treatment methods, until now the diseases of lower limb arteries (DLLA) are one of the most urgent problems of the modern vascular surgery and medicine in general. Intensive development of roentgen-endovascular methods of treatment for the diseases of lower limb arteries has led to a considerable revision of the tactics of management of this category of patients in the recent years. Despite the achievements of roentgen-endovascular surgery, frequency of obstructions after surgical revascularization of limbs remains high, both in early and late postoperative periods. It should also be noted that despite the intensive development of methods of therapy of patients with DLLA, frequency of limbs amputation in this category of patients remains high. One of the urgent problems of management of patients with DLLA after endovascular treatment is the problem of restenosis. In the recent years, new efficient methods of pharmacotherapy of DLLA have been developed and introduced into clinical practice, which allows significant improvement of medical prognosis in this category of patients and improvement of the outcomes. It should be noted that standard approaches to antithrombotic therapy in patients after endovascular surgeries based on use of antiaggregant drugs, can only decrease the rate of thrombotic complications, but not of restenosis, which, from the point of view of pathophysiology, is mainly hyperproliferative condition. Among promising approaches to treatment of restenosis, there is use of cilostazol, efficiency of which after endovascular surgeries on coronary and peripheral arteries has been proven in a number of studies.