Cilostazol is a selective, reversible inhibitor of phosphodiesterase type 3, which inhibits platelet aggregation and exerts a vasodilation effect. These therapeutic properties justified its use in the conservative treatment of chronic lower limb ischemia. Cilostazol is used worldwide for over 15 years, but has not been widely available in Poland.

Randomized clinical trials with placebo showed that the drug used at a dose of 100 mg twice daily increases the claudication distance of by an average of 30–40 meters. In addition, clinical observations indicate its potential benefits in patients with critical ischemia of the lower limbs, pointing out lower incidence of amputation and acceleration of ulcers healing.

The use of cilostazol, like aspirin, reduces the risk of stroke, and in patients after endovascular treatment (the femoro-popliteal stenting) reduces the risk of stent thrombosis and restenosis. The potential benefits of cilostazol in the combination with other antiplatelet agents are being questioned and remain subject to scientific debates.

Recently published studies indicate the potential benefits related to slowing progression of Alzheimer’s disease and reduced pulmonary artery pressure in patients treated with cilostazol.

This article summarizes current knowledge on the use of cilostazol and its limitations in the treatment of chronic ischemia of the lower limbs, and presenting the recommendations of the European Medicines Agency issued in 2013.