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Professor",[384,387],{"name":385,"class":386},"Japan Research Foundation for Clinical Pharmacology","UNKNOWN",{"name":388,"class":386},"Takeda Science Foundation - Medical Research Grant","100601520","phase-4-lacunar-stroke-hyperacute-clinical-utilization-of-novel-approach-regimens-rt-pa-vs-dapt-randomised-clinical-trial-100601520",false,"NCT07111559","Lacunar Stroke hyperAcute Clinical Utilization of Novel Approach Regimens: Rt-PA vs. DAPT Randomised Clinical Trial","A Multicenter Randomized Controlled Trial Comparing Tissue Plasminogen Activator With Dual Antiplatelet Therapy for Patients With Hyperacute Single Perforating Artery Infarction","LACUNAR-tPA","Inclusion Criteria:\n\n* Age ≥ 18 years.\n* Acute ischemic stroke within 4.5 hours from onset. If onset time is unknown because of impaired consciousness or aphasia, use the \"last known well\" time.\n* A single perforating-artery infarct on brain MRI:\n\nlocated in the corona radiata, putamen, internal capsule, thalamus, or pons; solitary, mainly round or oval, with a maximum diameter ≤ 20 mm; lesions only in the centrum semiovale are not allowed, but extension from the above sites into the centrum semiovale is allowed.\n\n* No disability in daily life before the stroke (modified Rankin Scale ≤ 1).\n* National Institutes of Health Stroke Scale (NIHSS) score ≤ 5.\n* Written informed consent obtained.\n\nExclusion Criteria:\n\n* Antithrombotic therapy considered inappropriate because of active bleeding, low platelet count, or similar conditions.\n* Any contraindication to intravenous rt-PA, without blood pressures.\n* ≥ 50 % stenosis or occlusion of the artery responsible for the stroke \\* (see note below).\n* Diseases that require anticoagulation (e.g., atrial fibrillation, deep-vein thrombosis) \\*\n* Inability to take medicine orally.\n* Any other reason judged by the principal investigator or co-investigators to make participation inappropriate.\n\nNote: This study targets hyper-acute stroke within 4.5 hours. To avoid treatment delay, items marked with \\* must be judged using the similar examinations that each site normally performs before rt-PA administration.","ALL","18 Years",{"count":400,"type":401},500,"ESTIMATED","INTERVENTIONAL",[404],"PHASE4","The goal of this clinical trial is to learn if a combination of antiplatelet drugs works better than intravenous tissue plasminogen activator to treat small ischemic stroke (lacunar stroke). The main questions it aims to answer are:\n\nIs a combination of antiplatelet drugs non-inferior to the current standard tissue plasminogen activator treatment? Does a combination of antiplatelet drugs reduce the bleeding complications than tissue plasminogen activator?\n\nResearchers will compare a combination of antiplatelet drugs to tissue plasminogen activator to see if a combination of antiplatelet drugs works to treat small ischemic stroke (lacunar stroke).\n\nParticipants will:\n\nTake a combination of antiplatelet drugs or be given intravenous tissue plasminogen activator Check the neurological status 3 months after stroke, in-person, by phone, or by mail.",[407,408,409],"Lacunar Stroke","Stroke","Ischemic Stroke",[9,411,15,412,413,414],"tissue-plasminogen activator","dual antiplatelet therapy","minor stroke","lacunar stroke","2026-06-04",{"date":417,"type":418},"2026-06-05","ACTUAL",{"date":420,"type":418},"2025-08-01",{"date":422,"type":401},"2029-03-31",{"name":5,"class":6},28]