Abstract
A case of acute ischemic stroke with ipsilateral carotid artery stenosis and atrial fibrillation is reported. In this case, carotid artery stenting (CAS) was performed after the initiation of oral anticoagulation with warfarin and dual antiplatelet therapy with aspirin and clopidogrel. However, such triple therapy is thought to increase the risk of bleeding complications. Three months after the CAS, the clopidogrel was stopped, but the aspirin and warfarin were continued for another three months. After that, the aspirin was stopped, and oral warfarin was continued for more than two years. Repeated carotid ultrasonography revealed no in-stent re-stenosis. The patient had neither recurrent stroke nor cardiovascular events. If CAS is required in patients with atrial fibrillation, triple or double antithrombotic therapy is needed for several months; however, after this period, monotherapy with an oral anticoagulant appears to be safe.
