Are There Any Indications for Oral Anticoagulation in Patients with Major Atherosclerotic Disease?
Atherosclerotic narrowing of the major intracranial arteries (carotid siphon; anterior, middle or posterior cesrebral arteries; vertebral artery; basilar artery) causes approximately 5-10% of ischemic strokes. Currently, the benefit of secondary stroke-preventive therapy in patients with TIA or stroke caused by this intracranial disease is not codified. Although aspirin is frequently used, its efficacy in patients with intracranial large-artery stenosis is not clearly established. Extensive data are available on the rate of stroke in patients with carotid siphon or MCA stenosis or vertebral stenosis. The results of these studies suggest that patients with vertebral or basilar artery stenosis have a better prognosis than those with carotid siphon or MCA stenosis. Intracranial MCA Stenosis or Vertebral Stenosis A small retrospective, nonrandomized study shows that: (a) patients with posterior circulation stenosis have a higher rate of stroke in the same territory as the stenotic vessel t
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