New Data and the Covid-19 Pandemic Mandate a Rethink of Antiplatelet Strategies in Patients With TIA or Minor Stroke Associated With Atherosclerotic Carotid Stenosis

The 2017 European Society for Vascular Surgery (ESVS) carotid  guidelines, as well as a subsequent literature review, recommend clopidogrel monotherapy or combination aspirin + dipyridamole in recently symptomatic patients not undergoing carotid endarterectomy (CEA).1,2 In patients scheduled for CEA, antiplatelet therapy was recommended throughout the peri- operative period and in the long-term.1 It was advised that early treatment with aspirin + clopidogrel or aspirin + dipyridamole ‘may be considered’ in order to prevent early recurrent events in patients with transient ischaemic attack (TIA) or minor ischaemic stroke and an ipsilateral 50– 99% stenosis awaiting expedited CEA (Evidence IIb, Level C).
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Tags: For Debate: Hot Topic Source Type: research