What is the recommendation for patients with AIS and extracranial carotid or vertebral arterial dissection?
For patients with AIS and extracranial carotid or vertebral arterial dissection, treatment with either antiplatelet or anticoagulant therapy for 3 to 6 months is reasonable. A randomized, open-label phase II feasibility trial of anticoagulation versus antiplatelet therapy in 250 participants with extracranial carotid or vertebral artery dissection found no difference in rates of ipsilateral stroke or all-cause mortality within 3 months of randomization in an intention-to-treat analysis, and there were no significant differences between groups. There was also no difference in rates of major bleeding.