Can you answer the questions about this case ahead of joining the live teaching session?

A 54-year-old male with a history of transient ischemic attack (TIA) presented with two episodes of acute ischemic stroke. The first episode, in 2006, was successfully treated with intravenous tissue plasminogen activator (IV TPA), intra-arterial TPA, and mechanical thrombectomy. The second episode occurred after a brief interruption of aspirin therapy and was managed conservatively due to delayed presentation. Despite dual antiplatelet therapy (DAPT), the patient developed a persistent M1 occlusion with subsequent thrombus formation. Subsequent investigations, including transcranial Doppler (TCD) and cerebral angiography, failed to identify a clear embolic source. The patient underwent carotid endarterectomy (CEA), which revealed focal shelf-like projections of fibrotic intima without atherosclerotic changes. Since the procedure, the patient has remained stroke-free.

This program is funded by an independent grant from Bayer. This online education program has been designed solely for healthcare professionals in the USA. The content is not available for healthcare professionals in any other country.

Can you answer the questions about this case ahead of joining the live teaching session?

A 65-year-old male presents to your clinic following a recent ischemic stroke. He has a history of hypertension, hyperlipidemia, and type 2 diabetes. His imaging reveals a large artery atherosclerosis in his left internal carotid artery. He was previously intolerant of aspirin due to significant gastrointestinal upset.

1. What are the current standard antithrombotic options for this patient?
2. What specific factors would you consider when assessing the suitability for an anticoagulant?
3. What pros and cons exist of the current anticoagulant therapies?

This program is funded by an independent grant from Bayer. This online education program has been designed solely for healthcare professionals in the USA. The content is not available for healthcare professionals in any other country.

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