Journal of Atherosclerosis and Thrombosis
Online ISSN : 1880-3873
Print ISSN : 1340-3478
ISSN-L : 1340-3478
Effectiveness and Limitations of Intravenous rt-PA Therapy in Patients with Mild Cerebral Infarction
Ichiro DeguchiShinichi TakahashiSatoshi Suda
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JOURNAL OPEN ACCESS Advance online publication

Article ID: RV22034

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Abstract

Recombinant tissue plasminogen activator (rt-PA), specifically alteplase, remains the standard treatment for acute cerebral infarction across all stroke subtypes. However, per recent randomized controlled trials (RCTs), individuals with mild cerebral infarction, medical management alone without rt-PA can yield functional outcomes comparable to those achieved with thrombolytic therapy. This has sparked ongoing debate regarding the necessity of rt-PA administration in cases of mild stroke. Nonetheless, certain individuals with mild cerebral infarction derive clear benefits from rt-PA therapy. Therefore, an individualized treatment approach should be prioritized over a uniform thrombolytic strategy in these cases. This review examines the therapeutic efficacy and limitations of rt-PA therapy for mild cerebral infarction, integrating evidence from prior clinical studies with the authors’ perspectives.

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