By indirect comparison, clopidogrel was slightly less effective than ticlopidine, but confidence intervals overlapped widely, and most authorities accept comparable efficacy. Clopidogrel was well tolerated, with serious side-effects comparable to or fewer than aspirin. Clopidogrel is marketed in the U.S. as Plavix, given 75 mg once daily. Despite 50 years of controversy, it remains unclear whether warfarin is beneficial for patients with cerebrovascular disease and how it compares to antiplatelet agents.
Anecdotal experience suggests it is efficacious, but solid clinical data are lacking.
It is increasingly clear that patients with cerebrovascular disease are at particular risk for warfarin-related intracerebral bleeding. Pending future data, if warfarin is used for patients with primary cerebrovascular disease, it should probably be reserved for selected patients who fail antiplatelet therapy, seeking a target INR of 2.0-2.5. Both the surgical and medical groups received aspirin. This technique usually results in lesser degrees of stenosis being called compared to the usual clinical estimates at most hospitals.