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We conducted a retrospective,multicenter study to compare the efficacy of warfarin with aspirin for the prevention of major vascular events(ischemic stroke,myocardial infarction,or sudden death)in patients with symptomatic stenosis of a major intracranial artery.Patients with 50 to 99%stenosis of an intracranial artery(carotid,anterior,middle,or posterior cerebral; vertebral;or basilar)were identified by reviewing the results of consecutive angiograms performed at participating centers between 1985 and 1991.Only patients with TIA or stroke in the territory of the stenotic artery qualified for inclusion in the study.This study suggests a favorable risk/benefit ratio for warfarin compared with aspirin for the prevention of major vascular events in patients with symptomatic intracranial large-artery stenosis.A prospective,randomized study is needed to confirm these findings. |
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