Efficacy and safety of intravenous thrombolysis in patients with mild acute ischemic stroke

ObjectiveTo evaluate the efficacy and safety of intravenous thrombolysis in patients with mild acute ischemic stroke (AIS).MethodsIn this retrospective cohort study, adult patients with mild AIS within 4.5 hours of onset between July 2009 and December 2024 were enrolled from four hospitals in Zhejiang province. Mild AIS was defined as a National Institutes of Health Stroke Scale (NIHSS) score ≤5, with a limb motor NIHSS score of 0, and a NIHSS score ≥2 in any of the following items: gaze, visual fields, facial palsy, limb ataxia, sensation, language, dysarthria, or neglect. Logistic regression and general linear models were used to assess the impact of intravenous thrombolysis on 3-month functional outcomes and safety endpoints.ResultsAmong 347 enrolled patients, 206 (59.4%) received intravenous thrombolysis. The proportion of patients achieving a favorable functional outcome (modified Rankin Scale score 0-1) at 3 months was significantly higher in the thrombolysis group than that in the non-thrombolysis group (76.2% vs. 66.0%, adjusted OR=1.729, 95%CI: 1.016-2.940, Pvs. 12.8%, adjusted OR=0.074, 95%CI: 0.015-0.379, PP>0.05).ConclusionIntravenous thrombolysis can significantly improve 3-month functional outcomes and reduce mortality in patients with mild AIS, without increasing the risk of hemorrhagic transformation.