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The optimal choice and duration of antithrombotic treatment for stroke prevention are debated, particularly beyond 3\u2009months after symptom onset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>TREAT-CAD (TREATment of Cervical Artery Dissection) was a randomized controlled trial with blinded outcome assessment comparing non-inferiority of aspirin to anticoagulation (Vitamin-K-antagonists) in participants with symptomatic, Magnetic-Resonance-(MR)-imaging-verified cervical artery dissection. TREAT-CAD could not establish non-inferiority of aspirin to anticoagulation at 3\u2009months. Thereafter participants could continue antithrombotic medication and obtained a standardized assessment of clinical and MR-Imaging outcomes between 3 and 6\u2009months. As crossover to the other treatment arm was possible, we performed an as-treated analysis as main analysis. The main outcomes were new clinical (ischemic stroke, intracranial\/major extracranial bleeding, or death) and new MR-Imaging outcomes (ischemic or hemorrhagic brain lesions).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 122 participants in the as-treated analysis, 3\/93 (3.2%) aspirin-treated participants had new clinical (n\u2009=\u20091) and MRI-outcomes (n\u2009=\u20092) between 3 and 6\u2009months while 1\/29 (3.4%) anticoagulated participants had an MRI-outcome (n\u2009=\u20091). All outcome events were hemorrhagic while ischemic events were absent. No deaths occurred. This yields an absolute difference of 0.2% (95% CI \u22128.0% to 7.5%, p\u2009=\u20091.0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and conclusion<\/jats:title>\n                    <jats:p>During the extended follow-up period of a controlled randomized trial comparing aspirin to anticoagulation in cervical artery dissection, outcomes between 3 and 6\u2009months after randomization occurred rarely, similarly often in both groups and were exclusively hemorrhagic events. Thus, studies balancing benefits versus harms of antithrombotic treatment beyond 3\u2009months are warranted. Registration: ClinicalTrials.gov: NCT02046460. https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02046460.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23969873251315362","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T01:54:31Z","timestamp":1738806871000},"page":"871-881","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["The 6-months follow-up of the TREAT-CAD trial: Aspirin versus anticoagulation for stroke prevention in patients with cervical artery dissection"],"prefix":"10.1093","volume":"10","author":[{"given":"Stefan T","family":"Engelter","sequence":"first","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland 1"},{"name":"Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland 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