In this issue of Cardiovascular Revascularization Medicine , Yang et al. report the results from their randomized single-center clinical trial comparing the impact of dual antiplatelet therapy (DAPT) for six months with ticagrelor and aspirin versus one month of DAPT with clopidogrel and aspirin on thrombus burden detected by optical coherence tomography (OCT) in patients with peripheral arterial disease (PAD). The authors found ticagrelor to be associated with a significantly reduced white thrombus burden at 6-month follow-up OCT (median volume/stent length 0.067 vs. 0.014 mm ³ /mm, p=0.05). Whether this reduced white thrombus volume is clinically meaningful remains unknown. They found no significant differences between groups in Rutherford classification or ABI at 6-month follow-up; however, the study was not sufficiently powered to detect differences in clinical outcomes.