Comparison of guidelines recommendation on minor stroke and level of evidence
| Guidelines | Recommendation | COR/LOE |
| Chinese Stroke Association 2023 | For patients with acute ischaemic stroke with mild and disabling symptoms within 4.5 hours of onset, intravenous thrombolysis is recommended. | IIa/B |
| For patients with acute ischaemic stroke with mild non-disabling symptoms (NIHSS 0–5) within 4.5 hours, intravenous thrombolysis is not routinely recommended. | III/B | |
| For patients with minor ischaemic stroke and high-risk transient ischaemic attack who did not receive intravenous thrombolysis, dual antiplatelet therapy is initiated within 24 hours of symptom onset if their NIHSS score is <3. | I/A | |
| For patients with moderate ischaemic stroke (NIHSS score of 4–5) who present within 24 hours of symptom onset, ticagrelor plus aspirin for 30 days (ticagrelor loading dose of 180 mg on the first day, followed by 90 mg two times per day) may reduce the risk of recurrent stroke and death within 30 days. | IIb/B | |
| American Stroke Association 2019 | For otherwise eligible patients with mild stroke presenting in the 3-hour to 4.5-hour window, treatment with intravenous alteplase may be reasonable. Treatment risks should be weighed against possible benefits. | IIb/B |
| European Stroke Organisation (ESO) 2023 | For patients with acute minor, disabling ischaemic stroke of <4.5-hour duration, we recommend intravenous thrombolysis with alteplase. | Moderate,strong |
| For patients with acute minor non-disabling ischaemic stroke of <4.5-hour duration, we suggest no intravenous thrombolysis. | Moderate, weak | |
| For patients with acute minor non-disabling ischaemic stroke of <4.5-hour duration, and with proven large-vessel occlusion, there is insufficient evidence to make an evidence-based recommendation. | Very low | |
| For patients with acute minor non-disabling ischaemic stroke of <4.5-hour duration, and with proven large-vessel occlusion, there is insufficient evidence to make an evidence-based recommendation. | Expert consensus | |
| For patients with acute ischaemic stroke of <4.5-hour duration, and rapidly improving neurological signs, which are still disabling, there is insufficient evidence to make a recommendation. | Very low | |
| For patients with acute ischaemic stroke of <4.5-hour duration, and rapidly improving neurological signs, which are still disabling, intravenous thrombolysis with alteplase is recommended. | Expert consensus |
COR, Classification of recommendation; LOE, Level of Evidence; NIHSS, National Institutes of Health Stroke Scale.