Challenge to the management of high-risk stroke patients with multiple-site occlusive vascular disease

Stroke patients are at high risk of secondary vascular events. Although in the short term the risk of experiencing a second stroke is high, in the long term patients are more likely to have myocardial infarction. Many stroke patients have also developed polyvascular disease in the form of coronary artery disease and peripheral arterial disease, which is a marker of increased morbidity and mortality in patients with non-cardioembolic ischemic stroke. Despite the high risk of events in these patients, current evidence-based guidelines make very few recommendations that address the need to detect and manage polyvascular disease following a stroke. Optimised Stroke Care for Re-Admission Reduction in Europe (OSCARE) is an initiative that has been set up to address some of these shortcomings.