Efficacy and Safety of Reperfusion Therapy for Minor Ischemic Stroke in China

NCT ID: NCT07322835

Last Updated: 2026-01-07

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Total Enrollment: 5400 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2026-01-01
• Study Completion Date: 2027-06-30

Brief Summary

Acute ischemic stroke is the most common type of stroke in China, accounting for 69.6% -72.8% of new strokes. In recent years, the proportion of mild stroke (NIHSS ≤ 5 points) has gradually increased, exceeding 50%, and the recurrence rate of stroke within one year is 13.2%, with a mortality rate of 6.3%, and 4% -10% may experience early deterioration of neurological function within 72 hours. At present, the main treatment for mild ischemic stroke is antiplatelet aggregation or anticoagulation drugs, but there are still 10% -20% of patients with residual neurological disability. There is still controversy over whether acute reperfusion therapy (including intravenous thrombolysis and endovascular intervention therapy) can improve the prognosis of such patients. In addition, it has been confirmed that beyond the time window thrombolysis is effective for selected ischemic stroke patients, but it is urgent to clarify whether mild ischemic stroke patients can benefit from receiving beyond the time window thrombolysis. Due to the limited evidence and inconsistent conclusions on the efficacy and safety of reperfusion therapy in patients with mild stroke, it is urgent to have a deeper understanding of the current status of reperfusion therapy for mild ischemic stroke in China based on real clinical data, and systematically compare the efficacy and safety of reperfusion therapy (including intravenous thrombolysis and endovascular intervention therapy) with standard drug therapy for this type of patient. This project plans to conduct a nationwide multicenter prospective cohort study to evaluate the differences in excellent neurological function prognosis (mRS ≤ 1) and symptomatic intracranial hemorrhage rate among patients with mild ischemic stroke who receive reperfusion therapy (intravenous thrombolysis ± endovascular intervention therapy) compared to standard drug therapy at 90 days, in order to guide accurate clinical decision-making. The research results have significant implications for improving the prognosis of patients with mild ischemic stroke, and will also lay an important foundation for future large-scale randomized controlled studies to explore the optimal treatment strategies for mild stroke.

Conditions

Minor Ischemic Stroke

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

Reperfusion therapy cohort

intravenous thrombolysis ± endovascular therapy, endovascular therapy alone

No interventions assigned to this group

Standard of care cohort

Recommended by guidelines for secondary stroke prevention, e.g. dual/mono antiplatelet, antihypertensive or lipid-lowing therapy, et al

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

1. Age >18 year

2. Pre-stroke mRS ≤1

3. Diagnosis of ischemic stroke, confirmed by imaging (CT or MRI)

4. Stroke onset or last seen well (LSW) to visit ≤ 24h

5. NIHSS ≤ 5

6. Receive standard medication or IVT (TNK or rtPA) ± EVT, or EVT alone; for IVT beyond standard time window, initiation of treatment must occur within 4.5-24h of last seen well and ASPECTs≥7 or Perfusion lesion-ischemic core mismatch (ischemic core volume <70mL, mismatch rate >1.2, mismatch volume >10mL or mismatch between the presence of an abnormal signal on DWI and no visible signal change on FLAIR)

7. Patients or their eligible surrogates provided informed consent

Exclusion Criteria

1. Pregnant or breastfeeding women

2. Patients who already received reperfusion therapy for the current stroke before arriving at the hospital

3. Participation in another interventional clinical trial that could interfere with the outcomes of this study

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

First Affiliated Hospital, Sun Yat-Sen University

OTHER

Sponsor Role: lead

Responsible Party

Jinsheng Zeng, MD, PhD

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Jinsheng Zeng, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

First Affiliated Hospital, Sun Yat-Sen University

Locations

The First Affiliated Hospital, Sun Yat-Sen University

Guangzhou, Guangdong, China

Countries

China

Central Contacts

Jinsheng Zeng, MD, PhD

Role: CONTACT

zengjs@pub.guangzhou.gd.cn

+86-13322800657

Yicong Chen, MD, PhD

Role: CONTACT

chenyc37@mail.sysu.edu.cn

+86-15914325270

Facility Contacts

Jinsheng Zeng, MD, PhD

Role: primary

zengjsh@mail.sysu.edu.cn

+86-13322800657

Other Identifiers

RERISE

Identifier Type: -

Identifier Source: org_study_id