What are the knowledge gaps in treating stroke or TIA patients with evidence of an aortic arch atheroma?
Knowledge gaps within this area include determining the effectiveness of long-term dual antiplatelet therapy (DAPT) with aspirin and clopidogrel compared with aspirin monotherapy to prevent recurrent stroke; determining the effectiveness of anticoagulation with either warfarin or a direct-acting anticoagulant compared with aspirin monotherapy to prevent recurrent stroke; and determining the effectiveness of combination antiplatelet and anticoagulation therapy compared with aspirin monotherapy to prevent recurrent stroke. Optimal treatment strategies depending on plaque morphology and duration of treatment strategies also remain unknown.