Warfarin and low-dose aspirin for stroke prevention from severe intracranial stenosis.
Management of symptomatic, intracranial, large-arterial atherosclerosis is controversial. We assessed the safety and efficacy of combining warfarin and low-dose aspirin to prevent stroke from intracranial atherosclerotic stenosis failing prior treatment with either aspirin or warfarin. Patients with severe intracranial stenosis were prescribed combination therapy, warfarin (international normalized ratio [INR] 2 to 3) and aspirin 81 mg daily. Ten men and six women treated with combination therapy had one recurrent ischemic event during 382 months of therapy. No patient suffered a myocardial infarction or sudden vascular death. No serious hemorrhagic complication occurred. The combination of warfarin and low-dose aspirin seems safe and effective in preventing recurrent stroke from symptomatic, intracranial, large-arterial occlusive disease after failure with either aspirin or warfarin monotherapy.
Bekavac
I
I
Department of Neurology, MetroHealth Medical Center, Cleveland, OH, USA; Department of Neurology, The Cleveland Clinic Foundation, Cleveland, OH. USA.
Hanna
J P
JP
Sila
C A
CA
Furland
A J
AJ