Intracranial Large Artery Atherosclerosis Recommendations for Intracranial Large Artery Atherosclerosis Referenced studies that support recommendations are summarized in online Data Supplements 20 27. COR LOE Recommendations Antithrombotic Therapy In patients with a stroke or TIA caused by 50% to 99% stenosis of a major intracranial artery, aspirin 325 mg/d is recommended in prefer- ence to warfarin to reduce the risk of recurrent ischemic stroke and vascular death.335,336 In patients with recent stroke or TIA (within 30 days) attributable to severe stenosis (70% 99%) of a major intracranial artery, the addition of clopidogrel 75 mg/d to aspirin for up to 90 days is reasonable to further reduce recurrent stroke risk.336 339 In patients with recent (within 24 hours) minor stroke or high-risk TIA and concomitant ipsilat- eral >30% stenosis of a major intracranial artery, the addition of ticagrelor 90 mg twice a day to aspirin for up to 30 days might be considered to further reduce recurrent stroke risk.340 In patients with stroke or TIA attributable to 50% to 99% stenosis of a major intracranial artery, the addition of cilostazol 200 mg/day to aspirin or clopidogrel might be considered to reduce recurrent stroke risk.341 344 CLINICAL STATEMENTS AND GUIDELINES Kleindorfer In patients with stroke or TIA attributable to 50% to 99% stenosis of a major intracranial artery, the usefulness of clopidogrel alone, the combination of aspirin and dipyridam- ole, ticagrelor alone, or cilostazol alone for secondary stroke prevention is not well established. 