It inhibits the enzyme adenosine deaminase which normally breaks down adenosine. This inhibition leads to increased levels of adenosine. Adenosine activates the enzyme adenylate cyclase which leads to increased cyclic AMP (cAMP) synthesis.
Dipyridamole also inhibits the enzyme phosphodiesterase which normally breaks down cAMP.

Both of these mechanisms lead to increased levels of cAMP within platelets. cAMP impairs platelet aggregation.

Modified release dipyridamole is used in conjunction with aspirin (Aggrenox®) in the secondary prevention of stroke and transient ischemic attack.

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FDA gives green light to Aggrenox for prevention of recurrent stroke - Food and Drug Administration - Brief Article - Statistical Data Included
From Drug Store News, 12/13/99

The FDA has approved Aggrenox (aspirin/extended-release dipyridamole) 25 mg/200 mg capsules dosed twice daily for the prevention of stroke in patients who have experienced a previous stroke or a transient ischemic attack. The FDA approval was based on the results of the European Stroke Prevention Study 2, the largest recurrent stroke prevention trial ever conducted. Results from ESPS2 indicated that Aggrenox reduces the risk of recurrent stroke by 37 percent compared with a placebo. The study also showed that Aggrenox, which is manufactured by Boehringer Ingelheim, reduces the risk of recurrent stroke by 22 percent over aspirin (50 mg/day) alone.

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