ABSTRACT

All patients with symptomatic internal carotid artery (ICA) stenosis should be placed on antithrombotic therapy. The major options for the clinician are antiplatelet agents or oral anticoagulants.

There is virtually no head-to-head data comparing individual antiplatelet agents or antiplatelet agents vs. warfarin for patients with ICA stenosis. Therefore, the clinician must rely on ‘‘global’’ stroke prevention studies, which typically include a combination of patients with large vessel atherosclerotic, lacunar, and cryptogenic stroke. In addition, many of the major trials conducted in the last three decades have enrolled both transient ischemic attack (TIA) and stroke patients.