Thirty-five years have demonstrated conclusively that stroke is a preventable disease. Clinical trials have determined that: anticoagulants prevent stroke when thrombi are in the left side of the heart and are of benefit in the presence of atrial fibrillation. Aspirin and ticlopidine reduce the risk of stroke in symptomatic patients. No other platelet-inhibiting drugs alone or in combination have a proven value. Primary stroke prevention trials remain to be done in the population most likely to benefit from aspirin. Bypass surgery has failed to prevent stroke; patients should not be subjected to this procedure except in an experimental setting. The appropriate indications and benefits from carotid endarterectomy in symptomatic and asymptomatic patients remain uncertain; present studies will give definitive answers to this 35-year-old question.

Keywords:
Stroke prevention, Stroke, Decline, Platelet inhibitors, Bypass surgery, Carotid endarterectomy
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© 1991 S. Karger AG, Basel
1991
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