When compared to those in the embolic group, patients in the ICAS group underwent intravenous recombinant tissue plasminogen activator treatment less frequently (64.9% vs. 44.0%, p = 0.001) and had significantly longer onset-to-puncture times (258 ± 132 min vs. 333 ± 164 min, p < 0.001). Here, PLAT is linked to familial isolated congenital asplenia.