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Hospital","Ube",{"type":44,"coordinates":358},[359,360],131.25111,33.94306,{"lat":360,"lon":359},[363],{"name":364,"role":33,"phone":365,"phoneExt":11,"email":366},"Hideyuki Ishihara","+81-836-22-2111","hishi@yamaguchi-u.ac.jp",{"facility":368,"status":40,"city":369,"state":11,"zip":11,"country":42,"cosmosGeoPoint":370,"geoPoint":374,"contacts":375},"Juntendo University Urayasu Hospital","Urayasu",{"type":44,"coordinates":371},[372,373],139.90055,35.65879,{"lat":373,"lon":372},[376],{"name":377,"role":33,"phone":378,"phoneExt":11,"email":379},"Takao Urabe","+81-47-353-3111","t_urabe@juntendo.ac.jp",{"type":30,"investigatorFullName":29,"investigatorTitle":381,"investigatorAffiliation":5,"oldNameTitle":11,"oldOrganization":11},"Associate Professor",[383,386],{"name":384,"class":385},"Japan Research Foundation for Clinical Pharmacology","UNKNOWN",{"name":387,"class":385},"Takeda Science Foundation - Medical Research Grant","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":398,"type":399},500,"ESTIMATED","INTERVENTIONAL",[402],"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.",[405,406,407],"Lacunar Stroke","Stroke","Ischemic Stroke",[9,409,15,410,411,412],"tissue-plasminogen activator","dual antiplatelet therapy","minor stroke","lacunar stroke","2026-06-04",{"date":415,"type":416},"2026-06-05","ACTUAL",{"date":418,"type":416},"2025-08-01",{"date":420,"type":399},"2029-03-31",{"name":5,"class":6},28]