Katsuura

Researchers are investigating whether a combination of antiplatelet drugs works as well as intravenous tissue plasminogen activator (rt-PA) in treating small ischemic strokes known as lacunar strokes. This phase 4 trial aims to determine if the dual antiplatelet therapy is not inferior to the current standard rt-PA treatment and if it reduces bleeding complications compared to rt-PA. Participants will receive either a low-dose rt-PA treatment (0.6 mg/kg alteplase) or a dual antiplatelet therapy consisting of aspirin 200 mg and clopidogrel 300 mg. Treatment is given during the hyperacute phase of stroke, within 4.5 hours of symptom onset. The study compares these two approaches to assess their effectiveness and safety. During the study, participants will be monitored for neurological status three months after their stroke. Assessments may be conducted in person, by phone, or by mail. The main outcome measured is the proportion of participants achieving an excellent outcome three months post-stroke. Safety and treatment effects will be closely observed throughout the trial.