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

NCT07322835 | Not Yet Recruiting DMC

• 1 other identifier: RERISE
• Study Type: observational
• Target: 5,400
• Locations: 1 country
• Sites: 1

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

Keywords

minor ischemic stroke; reperfusion therapy; intravenous thrombolysis; endovascular therapy

Outcome Measures

Primary Outcomes (1)

• Proportion of modified Rankin scale score 0-1

  Modified Rankin Scale score ranges from 0 to 6, and lower score means better functional independence.

  Day 90

Secondary Outcomes (8)

• Proportion of Modified Rankin Scale score 0-2

  Day 90

• Proportion of Modified Rankin Scale score 0-3

  Day 90

• Ordinal Modified Rankin Scale score

  Day 90

• Change from baseline in National Institutes of Health Stroke Scale

  Hour 24

• Change from baseline in National Institutes of Health Stroke Scale

  Hour 72

Other Outcomes (3)

• Proportion of symptomatic intracerebral hemorrhage (ECASS III)

  Day 7 or discharge

• Proportion of moderate or severe systemic bleeding (The GUSTO criteria)

  Day 7 or discharge

• Mortality

  Day 90

Study Arms (2)

Reperfusion therapy cohort

intravenous thrombolysis ± endovascular therapy, endovascular therapy alone

Standard of care cohort

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

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients with minor ischemic stroke (NIHSS ≤ 5) within 24h from onset

You may qualify if:

• Age \>18 year
• Pre-stroke mRS ≤1
• Diagnosis of ischemic stroke, confirmed by imaging (CT or MRI)
• Stroke onset or last seen well (LSW) to visit ≤ 24h
• NIHSS ≤ 5
• 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)
• Patients or their eligible surrogates provided informed consent

You may not qualify if:

• Pregnant or breastfeeding women
• Patients who already received reperfusion therapy for the current stroke before arriving at the hospital
• Participation in another interventional clinical trial that could interfere with the outcomes of this study

Sponsors & Collaborators

• First Affiliated Hospital, Sun Yat-Sen University: lead

Study Sites (1)

The First Affiliated Hospital, Sun Yat-Sen University

Guangzhou, Guangdong, 510080, China

Location

Study Officials

• Jinsheng Zeng, MD, PhD

  First Affiliated Hospital, Sun Yat-Sen University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Jinsheng Zeng, MD, PhD

CONTACT

+86-13322800657; zengjs@pub.guangzhou.gd.cn

Yicong Chen, MD, PhD

CONTACT

+86-15914325270; chenyc37@mail.sysu.edu.cn

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: December 10, 2025
• First Posted: January 7, 2026
• Study Start: January 1, 2026
• Primary Completion (Estimated): April 1, 2027
• Study Completion (Estimated): June 30, 2027
• Last Updated: January 7, 2026

Record last verified: 2025-12

Locations

CN (1)