Antithrombotic therapies in cerebrovascular disease: What should we use as secondary prevention in patients with carotid artery disease?

The optimal strategy for primary and secondary prevention of ischemic events in patients with carotid artery disease has been well studied in recent years. Currently, aspirin is generally prescribed for the primary prevention of stroke despite a number of trial results on effectiveness proving inconclusive. However, many agents have been investigated for the secondary prevention of carotid artery disease, including antiplatelet agents such as aspirin, dipyridamole, ticlopidine, and clopidogrel. Although large randomized controlled trials have been reported, the optimal antiplatelet agent or combination of antiplatelet agents has yet to be clearly defined.