During the year of hospital-wide consultations, many consultation orders were received from surgeons who sought help from the Department of Neurology for stroke patients who needed surgery, and the most common problem was that the antithrombotic medication they had been taking when surgery was needed was a problem that many patients and surgeons struggled with. Stroke patients often need long-term antithrombotic drugs to prevent stroke recurrence, and when surgery is needed, antithrombotic drugs may increase the risk of bleeding. To take or to stop, that is the question. Fortunately, this year someone has looked into this issue and given a guideline for your reference. Clinicians managing the use of perioperative antithrombotic drugs must weigh the risk of bleeding with continued use against the risk of thrombosis when the drug is discontinued. Translation: It is still necessary for the surgeon and neurologist to jointly assess the risks and benefits of discontinuing antithrombotic drugs. Here are the specific details: 1. Patients with a history of stroke should be routinely maintained on aspirin during dental procedures (Level A evidence). 2. Aspirin should be continued whenever possible in patients with a history of stroke undergoing invasive ocular anesthesia, cataract surgery, dermatologic procedures, ultrasound-guided transrectal prostate puncture biopsies, spinal/epidural surgery, and carpal tunnel surgery (Level B evidence). 3. Aspirin may be continued in some stroke patients undergoing vitreoretinal surgery, electromyography, transbronchial lung biopsy, colonoscopic polypectomy, upper gastrointestinal endoscopy and biopsy/sphincterotomy and abdominal ultrasound-guided biopsy (level C evidence). Translation: Discontinue aspirin as much as possible before minimally invasive procedures and operations with relatively small incisions in stroke patients. There is currently strong evidence for the idea that aspirin need not be discontinued for dental procedures; the rest of the evidence for minimally invasive procedures and operations is not at a high enough level, but is recommended whenever possible.