What is the evidence for the efficacy of cilostazol for secondary stroke prevention in patients with ischemic stroke related to small vessel disease?
The CSPS trial (Cilostazol for Prevention of Secondary Stroke) studied cilostazol in 1095 Japanese patients with noncardioembolic ischemic stroke. The results showed a significant reduction in the risk of recurrent stroke in the cilostazol treatment group compared to the placebo group. Subgroup analysis also showed a reduction in the risk of recurrent stroke in participants with lacunar stroke. Thus, the evidence suggests that cilostazol is effective for secondary stroke prevention in patients with ischemic stroke related to small vessel disease. 