Vertebrobasilar insufficiency medical therapy

In the recent decades, interventional therapy became more and more important with the medical therapy as the foundation of the whole treatment.Open surgery is rarely used because its high risk of complication comparing with the catheter-based therapy.

The principle of medical therapy is reducing the atherosclerotic and thrombotic risk. 1.Aspirin (75 to 325 mg daily) is strongly recommended to prevent ischemic events, if there is no contraindications. 2.If the patient is suitable to accept asprin due to contraindictions, clopidogrel (75 mg daily) or ticlopidine (250 mg twice daily) is suggested to treat the atherosclerosis of the extracranial vertebral arteries. 3.Three schemes is suggested to treat the patients with persisitently ischemic stroke or TIA due to extracranial vertebral atherosclerosis.

• (1).Aspirin (81 to 325 mg daily)
• (2).Aspirin (81 to 325 mg daily) combinated with the extended-release dipyridamole (25 and 200 mg twice daily)
• (3).clopidogrel (75 mg daily).^[1]

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