{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:14:15Z","timestamp":1792066455112,"version":"4.4.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Restenosis after carotid artery stenting (CAS) is associated with the risk of developing ischemic stroke. We aimed to evaluate the inhibitory effect of cilostazol addition on in-stent restenosis (ISR) in patients treated with CAS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>In a randomized, open-label, blind-end point trial, patients with symptomatic and asymptomatic carotid artery stenosis and scheduled for CAS were randomly assigned to adding cilostazol (50 or 100 mg, twice per day) on other antiplatelets from 3 days before CAS or not adding cilostazol. Concomitant use of other antiplatelets was unrestricted. ISR was diagnosed by a peak systolic velocity of at least 1.75 m\/s on duplex ultrasonography. The primary outcome was incidence of ISR within 2 years after CAS. Secondary outcomes included occurrences of cardiovascular events or any death and hemorrhagic events.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Participants were recruited from December 2010 to September 2015. Although the sample size was initially set to be 900 (450 in each group), 631 patients (mean age 69.9 years, 558 men, 325 in the cilostazol, and 306 in the noncilostazol group) were included in the primary analysis. Within 2 years\u2019 follow-up, ISR occurred in 31 of 325 patients (cumulative incidence 10.8%) in the cilostazol group and 46 of 306 patients (19.6%) in the noncilostazol group (hazard ratio, 0.64 [95% CI, 0.41\u20131.0];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.056). In the exploratory analysis, incidence of ISR beyond 30 days after CAS was lower in the cilostazol group than in the noncilostazol group (10.3% versus 19.3%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.040). Incidences of cardiovascular events or any death and hemorrhagic events were similar between the groups (6.2% versus 6.7% and 2.3% versus 1.4%, respectively).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>The addition of cilostazol to other antiplatelet agents could contribute to the reduction of ISR in the chronic stage of patients who underwent CAS, the authenticity of which depends on further studies with sufficient statistical power.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT01261234.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.124.047210","type":"journal-article","created":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T19:00:57Z","timestamp":1732561257000},"page":"2776-2785","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Randomized Controlled Trial of Cilostazol Addition for In-Stent Restenosis After Carotid Artery Stenting"],"prefix":"10.1161","volume":"55","clinical-trial-number":[{"clinical-trial-number":"nct01261234","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8133-3314","authenticated-orcid":true,"given":"Hiroshi","family":"Yamagami","sequence":"first","affiliation":[{"name":"Division of Stroke Prevention and Treatment (H.Y.), Institute of Medicine, University of Tsukuba, Japan."},{"name":"Department of Neurology, NHO Osaka National Hospital, Japan (H.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1558-4785","authenticated-orcid":true,"given":"Tomohiko","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan (T.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8529-6688","authenticated-orcid":true,"given":"Kuniaki","family":"Ogasawara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery (K.O.), Iwate Medical University, Shiwa, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9121-3245","authenticated-orcid":true,"given":"Izumi","family":"Nagata","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kokura Memorial Hospital, Kitakyushu, Japan (I.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4827-8410","authenticated-orcid":true,"given":"Yuji","family":"Matsumaru","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery (Y. Matsumaru), Institute of Medicine, University of Tsukuba, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3600-4842","authenticated-orcid":true,"given":"Shinichi","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hyogo Medical University, Nishinomiya, Japan (S.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3108-4361","authenticated-orcid":true,"given":"Makoto","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Institute for Biomedical Sciences (M.S.), Iwate Medical University, Shiwa, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyuki","family":"Nagatsuka","sequence":"additional","affiliation":[{"name":"Department of Neurology, Osaka Neurological Institute, Toyonaka, Japan (K.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Minematsu","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan, and Iseikai International General Hospital, Osaka, Japan (K.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0836-0495","authenticated-orcid":true,"given":"Yoji","family":"Nagai","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Facilitation Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Japan (Y.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4957-9450","authenticated-orcid":true,"given":"Chiaki","family":"Sakai","sequence":"additional","affiliation":[{"name":"Regulatory Science of Medical Device Development and Innovation, Kyoto University Graduate School of Medicine, Japan (C.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8372-356X","authenticated-orcid":true,"given":"Yasushi","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Division of Development and Discovery of Interventional Therapy, Tohoku University Hospital, Sendai, Japan (Y. Matsumoto)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Ezura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Hospital Organization Sendai Medical Center, Japan (M.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0208-2412","authenticated-orcid":true,"given":"Hideyuki","family":"Ishihara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yamaguchi University Hospital, Japan (H.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3289-1210","authenticated-orcid":true,"given":"Nobuyuki","family":"Sakai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Seijinkai Shimizu Hospital, Kyoto, Japan (N.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the CAS-CARE 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