ArticleFrontiers in neurology2025
Evaluating the effectiveness of intravenous alteplase in patients with minor non-disabling stroke and severe large vessel stenosis: a retrospective study.
Article in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Aim: The efficacy of intravenous alteplase thrombolysis in patients with minor non-disabling acute ischemic stroke with severe large vessel stenosis or occlusion remains uncertain. This study aimed to assess the clinical effectiveness of intravenous alteplase therapy compared to dual antiplatelet therapy (DAPT) in this specific high-risk population. Methods: We conducted a retrospective study of patients presenting with minor non-disabling strokes [National Institutes of Health Stroke Scale (NIHSS) score ≤ 5 with all item scores 0 or 1] and severe large vessel stenosis or occlusion across four hospitals in Yichang City, Hubei Province (January 2019-December 2024, Results: Among 396 included patients (median age 68 years, 67.9% male), 199 received alteplase treatment and 197 received DAPT. The alteplase group demonstrated significantly higher rates of excellent functional outcomes at 90 days compared to the DAPT group (79.9 vs. 56.9%, Conclusion: In summary, for patients with minor non-disabling stroke and severe large vessel stenosis or occlusion, intravenous alteplase administered within 4.5 h is associated with significantly better functional outcomes compared to DAPT, without increasing the risk of hemorrhagic complications. These findings support the use of thrombolysis in this specific patient population and highlight the need for randomized controlled trials to confirm these results.
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