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Updated: Jul 12, 2026
09:21
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Optimal pharmacological therapy for minor acute ischemic stroke: a network meta-analysis.
Shuo Feng1, Shibing Liu1, Hongxia Zhao1
1Department of Neurology, Shenyang Sujiatun District Central Hospital, Shenyang City, Liaoning, China.
Frontiers in Neurology
|July 10, 2026
Summary
Dual antiplatelet therapy (DAPT) and aspirin show promise for minor acute ischemic stroke (mAIS). Individual patient factors are crucial for selecting the optimal pharmacological treatment strategy.
Area of Science:
- Neurology
- Pharmacology
- Clinical Medicine
Background:
- Minor acute ischemic stroke (mAIS) constitutes over 50% of all ischemic strokes.
- Optimal pharmacological therapy for mAIS remains a subject of debate.
- This study addresses the need for evidence-based treatment guidelines for mAIS.
Purpose of the Study:
- To conduct a systematic review and network meta-analysis (NMA) comparing pharmacological therapies for mAIS.
- To evaluate the effectiveness and safety of various antithrombotic interventions for mAIS patients.
Main Methods:
- Systematic search of PubMed, Embase, Cochrane Library, and Web of Science databases up to June 1, 2025.
- Inclusion of randomized controlled trials (RCTs) and cohort studies on antithrombotic drugs for mAIS.
- Bayesian NMA performed using R 4.5.1 and STATA 15.1 to analyze outcomes like functional status, neurological improvement, hemorrhage, recurrent stroke, and mortality.
Main Results:
- Eleven studies involving 26,176 patients evaluated 9 antithrombotic interventions.
- Single antiplatelet therapy (SAPT) and aspirin were most likely best for modified Rankin Scale (mRS) 0-1 and 0-2, respectively.
- Alteplase showed highest probability for early neurological improvement; aspirin had the lowest risk of intracranial hemorrhage. DAPT was most effective for reducing recurrent stroke and all-cause mortality.
Conclusions:
- Dual antiplatelet therapy (DAPT) and aspirin appear to be safe and effective for mAIS.
- Clinical decision-making should consider individual patient circumstances for personalized treatment strategies.
- Findings require validation through large-scale RCTs due to the limited study base.
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