Table 5.

Periprocedural Anti-thrombotic Therapy for all Carotid Stent Patients.

Medication	Pre-Procedure	Intra-Procedure	Post-Procedure	Post-Discharge
Heparin*	PRN	Maintain ACT 250–300 sec.*	PRN**	None
Aspirin	325 mg p.o. b.i.d.** (Begin 48 hours before)	None	325 mg† 1 to 2 tablets p.o. daily for 30 days	325 mg†,‡ 1 tablet p.o. daily thereafter
Clopidogrel	75 mg p.o. b.i.d. daily (Begin 48 hours before)	None	75 mg 1 tablet p.o. daily for 4 weeks	---
Ticlopidine (instead of Clopidogrel)	250 mg p.o. b.i.d. (Begin 48 hours before)	None	250 mg 1 to 2 tablets p.o. daily for 4 weeks	---

^*Bivalirudin may be substituted for heparin. Use in accordance with manufacturer’s instructions. ACT’s are not collected when bivalirudin is used as the procedural anticoagulant.

^**Heparin may be given post-procedure as needed.

^†May be substituted with 81 mg tablet if patient cannot tolerate 325 mg dosage.

^‡After four weeks, the aspirin may be substituted with Aggrenox b.i.d. or clopidogrel.