Treatment
Once your doctor has determined the cause of your TIA, the goal of
treatment is to correct the abnormality and prevent a stroke. Depending
on the cause of your TIA, your doctor may prescribe medication to reduce
the tendency for blood to clot, or may recommend surgery or a balloon
procedure (angioplasty).
Medications
Doctors use several medications to decrease the likelihood of a stroke
after a TIA. The medication selected depends on the location, cause,
severity and type of TIA. Two frequently prescribed types of drugs are:
-
Antiplatelet
drugs.
These medications make your platelets, one of the circulating blood
cell types, less likely to stick together. Clot formation is started
by sticky platelets when there's an injury to blood vessels. The
process is then completed by clotting proteins in blood plasma. The
most frequently used antiplatelet medication is aspirin. Aspirin is
also the least expensive treatment with the fewest potential side
effects. Your doctor may also consider prescribing Aggrenox, a
combination of low-dose aspirin and the antiplatelet drug
dipyridamole, to reduce blood clotting. The way dipyridamole works
differs slightly from aspirin. Another alternative to aspirin is an
antiplatelet drug clopidogrel (Plavix), which occasionally is used
in combination with aspirin. Ticlopidine (Ticlid) is another
antiplatelet medication that doctors occasionally recommend.
-
Anticoagulants.
These drugs include heparin and warfarin (Coumadin). They affect
clotting system proteins instead of platelet function. Heparin is
used short term and warfarin over a longer term. These drugs have a
profound anticoagulation effect and therefore require careful
monitoring.
Surgery and angioplasty (stenting)
If
you have a moderately or severely narrowed neck (carotid) artery, your
doctor may suggest carotid endarterectomy. This
preventive surgery clears carotid arteries of fatty deposits
(atherosclerotic plaques) before another TIA or stroke can occur. An
incision is made to open the artery, the plaques are removed, and the
artery is closed.
In selective cases, a procedure called carotid angioplasty, or stenting,
is an option. This procedure involves using a balloon-like device to
open a clogged artery and placing a small wire tube (stent) into the
artery to keep it open.
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