[Acute management of minor ischemic stroke]

This review summarizes acute-phase treatment for minor ischemic stroke, focusing on the latest evidence for reperfusion therapy and acute antithrombotic treatment. In patients with large vessel occlusion, the benefit of mechanical thrombectomy is not established and the risk of hemorrhage exists; therefore, indications should be judged carefully for each patient. Intravenous thrombolysis provides limited benefit in non-disabling cases, and dual antiplatelet therapy (DAPT) can be an option. For minor non-cardioembolic stroke, early DAPT is recommended, and the possible role of adding argatroban is promising, especially for suspected branch atheromatous disease. For cardioembolic stroke, early initiation of a direct oral anticoagulant is desirable in mild cases without a large infarct.