Standard-Dose Tenecteplase vs Low-Dose Alteplase for Acute Ischemic Stroke From Large-Vessel Occlusion

Is standard-dose tenecteplase (0.25 mg/kg) more effective and similarly safe as compared with low-dose alteplase (0.6 mg/kg) for patients with stroke?In this investigator-initiated, multicenter, randomized clinical trial of stroke with large-vessel-occlusion, tenecteplase (0.25 mg/kg) demonstrated superior substantial reperfusion on the initial angiography to alteplase (0.6 mg/kg), with no significant difference in symptomatic intracranial hemorrhage within 24 to 36 hours or 90-day mortality.In this randomized clinical trial, pretreatment with standard-dose tenecteplase before thrombectomy was more effective in terms of early recanalization and showed a comparable safety profile to low-dose alteplase.

Corresponding Author: Kazunori Toyoda, MD, PhD, Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center,6-1 Kishibe-shimmachi, Suita 564-8565, Japan (toyoda@ncvc.go.jp).

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