抄録
Background: Intima-media thickness (IMT) of the carotid artery can be used to evaluate atherosclerosis of the whole body. Carotid artery endarterectomy (CEA) is a typical treatment for carotid artery stenosis, but a detailed repair mechanism of the operated carotid intima-media site, under medicated cilostazol or aspirin, has not been clarified yet. We therefore started this observational study on temporal changes of the max IMT with particular emphasis on the operated area and report the results of an interim analysis.
Methods and objects: Patients who were free of ischemic heart disease, underwent CEA between June 2004 and April 2008 in our hospital and were medicated with aspirin or cilostazol alone as a postoperative management were enrolled. The max IMT was measured at the common carotid artery (CCA) and internal carotid artery (ICA) in the operated area, respectively, and at the CCA including the operated area after CEA by carotid duplex.
Results: Twenty-two patients and 26 patients were included in aspirin group (Group A) and cilostazol group (Group C), respectively, for the analysis set. In the historical background of patients and the stenosis characteristics, % stenosis rate before CEA and max IMT in all CCA areas after one month of CEA showed significant differences (p=0.039, 0.032, respectively) in the two groups. Not much difference was shown between the two groups on max IMT of the operated CCA area. In the operated ICA area, significant differences between 24–36 months value (p=0.040) in Group A and 1–12 months value (p=0.026) in Group C were shown. In all CCA areas, changing patterns of max IMT produced a significant difference (p=0.011: linear mixed effects model) in the two groups.
Discussion: In Group C, both the max IMTs of CCA and ICA in the operated area characteris-tically reached a plateau after 24 months. On the other hand, they tended to increase through the observation term in Group A. It is thought that this different growth pattern was based on different effects of aspirin and cilostazol in the blood vessel repairing process.
Conclusion: The results of this study suggest that aspirin and cilostazol have different effects on the vascular repair process after CEA or IMT thickening.
