that this is a medicine that can cause rats to bleed it's rat poison big dose of warfarin and the rat dies and they bleed so some patients don't like this because they don't like us to prescribe rat poison and as I said now we have newer agents that don't have that checkered history that work even better than warfarin and are very safe options now the other thing you can do is try to pull the atherosclerosis out so there's the surgical option which is called carotid endarterectomy this is a picture of somebody's carotid