What is the evidence for treating vertebrobasilar dolichoectasia with antithrombotic medication?
There are no prospective RCTs comparing antithrombotic therapies with observation alone. However, case series tend to suggest that anti-thrombotic therapy lowers the risk of recurrent ischemic events compared with the natural history. There are also no prospective RCTs comparing antiplatelet strategies (either aspirin or second-generation antiplatelet drugs) with anticoagulation.