Adjunctive butylphthalide plus antiplatelet therapy after IVT was associated with better 90-day functional recovery in this retrospective cohort; however, the observational design does not permit causal inference, and the safety findings are limited to the prespecified events reported here.
Key Findings
Results
After propensity score matching, the butylphthalide plus antiplatelet group had a higher rate of favorable 90-day functional outcome (mRS 0-2) than the antiplatelet-only group.
Favorable outcome was 73.1% vs. 48.1% (P = 0.009).
118 patients with acute ischemic stroke were treated with IVT between January 2024 and December 2025; 62 received butylphthalide plus antiplatelet therapy and 56 received antiplatelet therapy alone.
After propensity score matching, 52 patients were retained in each group.
Baseline characteristics were balanced between matched groups (all P > 0.05).
Results
The combination group had better secondary neurological and functional outcomes than the antiplatelet-only group.
The combination group had lower NIHSS scores and smaller infarct volumes (all P < 0.05).
The combination group had higher Barthel Index scores (P < 0.05).
Better CBF perfusion recovery was observed in the combination group (P < 0.05).
Results
Inflammatory and coagulation-related biomarkers were lower in the butylphthalide combination group.
Serum hs-CRP was lower in the combination group (P < 0.05).
Plasma D-dimer was lower in the combination group (P < 0.05).
Results
Adverse event rates did not differ significantly between the two groups.
The between-group comparison of adverse events gave P = 0.631.
Safety findings are limited to the prespecified events reported in the study.
Results
In multivariable logistic regression, treatment regimen was independently associated with 90-day functional prognosis.
The treatment regimen association had P = 0.009.
The model was used to identify factors associated with poor 90-day functional prognosis.
Conclusions
The authors note that the observational design limits causal inference.
The study was a single-center retrospective observational analysis.
Propensity score matching was used to balance baseline characteristics, but the design does not permit causal conclusions.
What This Means
This study looked back at records of 118 people who had an ischemic stroke (caused by a blocked blood vessel in the brain) and received clot-dissolving treatment through a vein. Some were also given a drug called butylphthalide along with standard antiplatelet (blood-thinning) medication, while others received antiplatelet medication alone. Researchers matched patients with similar characteristics, leaving 52 in each group, and compared how they were doing after 90 days.
In the matched groups, about 73% of those who got butylphthalide plus antiplatelet therapy had a good functional outcome (able to live with little or no disability), compared with about 48% of those on antiplatelet therapy alone. The combination group also had less severe stroke symptoms, smaller areas of brain damage, better blood flow recovery, lower blood markers of inflammation and clotting, and better daily-living scores. Rates of adverse events were not meaningfully different between groups.
This research suggests butylphthalide might be associated with better recovery after clot-dissolving treatment, but it cannot show that the drug caused the improvement. The study was retrospective, took place at a single center, and was small, and safety was assessed only for certain predefined events. Larger randomized trials would be needed to confirm these findings.
Cui J, Dai X, Liu C, Li X. (2026). Association of Butylphthalide Combined with Antiplatelet Therapy with Functional Recovery After Intravenous Thrombolysis in Acute Ischemic Stroke.. Journal of visualized experiments : JoVE. https://doi.org/10.3791/72353