Cilostazol may improve cognition better than clopidogrel in non-surgical adult patients with ischemic moyamoya disease: subanalysis of a prospective cohort

Ando, Satoshi; Tsutsui, Shouta; Miyoshi, Kenya; Sato, Shinpei; Yanagihara, Wataru; Setta, Kengo; Chiba, Takayuki; Fujiwara, Shunrou; Kobayashi, Masatoshi; Yoshida, Kenji; Kubo, Yoshitaka; Ogasawara, Kuniaki

doi:10.1080/01616412.2019.1580455

Cited by 18 publications

(16 citation statements)

References 19 publications

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“…Electroencephalography (EEG): High-voltage slow waves on EEG develop after the end of hyperventilation in children with MMD who present with cerebral ischemia. This is also known as the "rebuild-up" phenomenon [37].…”

Section: Supportive Findingsmentioning

confidence: 99%

“…A study was conducted to compare the efficacy of clopidogrel and cilostazol in improving neuropsychological test scores. In non-surgical adults with ischemic MMD, cilostazol was associated with better cognition improvement than clopidogrel [ 37 ]. Anti-platelet drugs are not recommended for asymptomatic adults due to an inherent risk of developing an ICH in almost half of the patients [ 31 ].…”

Section: Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Moyamoya Disease: A Review of Current Literature

Gupta

Tyagi

Romo

et al. 2020

Cureus

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Section: Supportive Findingsmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Moyamoya Disease: A Review of Current Literature

Gupta

Tyagi

Romo

et al. 2020

Cureus

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“…Other recent Japanese studies demonstrated that antiplatelet agents different from aspirin (clopidogrel and cilostazol) effectively improved cerebral perfusion in adult patients with symptomatically ischemic MMA [80,81]. Moreover, some preliminary results suggest that patients treated with cilostazol show a greater improvement in cognitive evaluation than in those treated with clopidogrel [82].…”

Section: Medical Treatmentmentioning

confidence: 97%

Clinical Management of Moyamoya Patients

Canavero

Vetrano

Zedde

et al. 2021

JCM

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Moyamoya angiopathy (MMA) is a peculiar cerebrovascular condition characterized by progressive steno-occlusion of the terminal part of the internal carotid arteries (ICAs) and their proximal branches, associated with the development of a network of fragile collateral vessels at the base of the brain. The diagnosis is essentially made by radiological angiographic techniques. MMA is often idiopathic (moyamoya disease-MMD); conversely, it can be associated with acquired or hereditary conditions (moyamoya Syndrome-MMS); however, the pathophysiology underlying either MMD or MMS has not been fully elucidated to date, and this poor knowledge reflects uncertainties and heterogeneity in patient management. MMD and MMS also have similar clinical expressions, including, above all, ischemic and hemorrhagic strokes, then headaches, seizures, cognitive impairment, and movement disorders. The available treatment strategies are currently shared between idiopathic MMD and MMS, including pharmacological and surgical stroke prevention treatments and symptomatic drugs. No pharmacological treatment able to reverse the progressive disappearance of the ICAs has been found to date in both idiopathic and syndromic cases. Antithrombotic agents are usually prescribed in ischemic MMA, although the coexisting hemorrhagic risk should be considered. Surgical revascularization techniques, which are currently the best available treatment in symptomatic MMA, are associated with good long-term outcomes and reduced ischemic and hemorrhagic risks. Given the lack of dedicated randomized clinical trials, current treatment is mainly based on observational studies and physicians’ and surgeons’ expertise.

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“…Other antiplatelet agents, such as Clopidogrel and Cilostazol, are also useful for ischemic prevention in Moyamoya disease [11]. Japanese and Korean physicians have the most experienced using Cilostazol in Moyamoya patients [19,20]. Seo et al's upcoming report showed that nearly 10,000 patients from Korea who were prescribed antiplatelet benefited from reducing mortality, especially patients who received Cilostazol [21].…”

Section: The Role Of Antithrombotic Therapy In Moyamoya Diseasementioning

confidence: 99%

Medical Management in Moyamoya Disease

Uransilp¹,

Puengcharoen²,

Muengtaweepongsa³

2021

Moyamoya Disease - A Disease to Count on in Your Daily Practice

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Medical treatment seems to be not entirely helpful in the treatment of Moyamoya disease. No evidence supports the benefits of any drug treatment in Moyamoya disease. The ischemic or hemorrhagic event in Moyamoya disease is not preventable with any medical treatment. However, most of the physicians still prescribe the antithrombotic drug for Moyamoya patients with an ischemic event. Moreover, the standard guidelines recommend administering antithrombotic medications to treat Moyamoya with the ischemic event, even the risk of hemorrhagic complication. Antihypertensive drugs are routinely prescribed in Moyamoya patients with or without elevated blood pressure. A literature review about medical treatment in Moyamoya disease should help determine its use in this pathologic condition.

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Cilostazol may improve cognition better than clopidogrel in non-surgical adult patients with ischemic moyamoya disease: subanalysis of a prospective cohort

Cited by 18 publications

References 19 publications

Moyamoya Disease: A Review of Current Literature

Moyamoya Disease: A Review of Current Literature

Clinical Management of Moyamoya Patients

Medical Management in Moyamoya Disease

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