[Antithrombotic drugs and stroke: clinical trials and unanswered questions]

Stroke patients are at very high risk of recurrent vascular events. Antiplatelet agents (AAP) substantially decrease this risk but still 1 over 5 patients will have an other vascular event. Recent studies didn't show any benefit of AAP association (aspirin, clopidogrel) but other studies targetting higher risk patients are needed. Studies with new AAP are ongoing. Beside vascular risk reduction, other antithrombotic agents are used as thrombolytics in the acute phase of stroke. The rt-PA (recombinant tissue plasminogen activator) administered in the first 3 hours dissolves the clot, preventing death and handicap due to ischemic brain lesion. But time window is short and rt-PA increase the risk of hemorragic stroke. Combination of new thrombolytic agents and new imaging technics should permit to rise the number of treated patients.