Administration of Cilostazol Prior to Intravenous Alteplase for Acute Branch Atheromatous Disease: A Report of Three Cases

Patients with acute branch atheromatous disease often experience early neurological deterioration (END) in the first 24-h period, even after intravenous alteplase. Three cases treated with cilostazol, a phosphodiesterase 3-inhibitor, prior to intravenous alteplase with the aim of mitigating END are described. All three patients had no bleeding complications and good outcomes at 3 months, although two patients showed END within 24 h after intravenous alteplase.