Considering only cerebrovascular indications, are there circumstances in which you would use aspirin along with a DOAC in patients with atrial fibrillation and stroke?  

I will use aspirin 81 mg and a DOAC together in patients who "fail" (I hate that term) the DOAC. The combination was used in patients in the original DOAC trials, so it is not unreasonable. Not my first choice, but can be done. It is worth noting that the evidence does not support doing this upfront...

This is an important question. I would typically avoid using long-term antiplatelet added to DOACs in patients with non-valvular AF unless the patient has severe cardiovascular disease or a stent. I also often use it for a short-term period (up to 30 days) after a minor stroke or TIA, particularly w...

Dr. @Shadi Yaghi, As always thank you for your answers! This is a scenario my colleagues and I face (very) often, stroke (embolic looking or not) while on DOAC. (I’ve reviewed uptodate and medlink and am aware of the lack of concrete guidelines and that it’s often an expert consensus ...

I typically do not switch DOACs - I keep them on apixaban as a preference. For long-term antiplatelet use for patients with significant ICAD as an example, if no contraindication then would often consider cilostazol 100mg bid (after a short course of other, i.e., aspirin 81mg) to minimize the r...

I’m not a stroke/vascular trained neurologist, but to me here is it more interesting question.  I think I’ve seen this from cardiologists and if they prescribe these combo medications and I’m not sure what the data is for long-term complications from ICH look like, do stroke ...

Since the question involved only cerebrovascular indications, I would consider adding aspirin 81 mg daily in patients with significant intracranial atherosclerosis.