Valeria Caso, MD, PhD, FESO, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy, discusses the challenges of managing patients with atrial fibrillation (AF) suffering a stroke despite preventive treatment with oral anticoagulant therapy. In these cases there are two types of recurrence: cardioembolic stroke or stroke due to atherosclerosis or small vessel disease (SVD). The management approach should account for these differences and the respective risk factors. Previous research has demonstrated that changing the anticoagulant or adding aspirin to anticoagulant therapy provides no benefit to patients, however emerging technology such as carotid filters may provide a new avenue for secondary prevention. Prof. Caso expresses the need for more research, specifically randomized controlled trials, into new technologies like this, especially in the case of cardioembolic recurrence. This interview took place at the World Stroke Congress 2022 in Singapore.
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