Intravenous Tenecteplase Prior to Endovascular Treatment for Ischemic Stroke at 4.5 to 24 Hours

In patients with stroke due to an acute proximal middle cerebral artery occlusion beyond 4.5 hours of onset, is endovascular treatment (EVT) with preceding intravenous tenecteplase superior to EVT alone regarding functional outcomes?In this randomized clinical trial including 391 patients, functional independence (modified Rankin Scale score 0-2) at 90 days did not differ significantly between those receiving tenecteplase plus EVT (44.2%) and those undergoing EVT alone (43.2%).For stroke due to a proximal middle cerebral artery occlusion presenting directly to an EVT-capable center within 4.5 to 24 hours, thrombolysis with tenecteplase before EVT did not improve clinical outcomes vs EVT alone.

Corresponding Authors: Yongjun Wang, MD, China National Clinical Research Center for Neurological Diseases (yongjunwang@ncrcnd.org.cn), and Yunyun Xiong, MD, PhD, Department of Neurology (xiongyunyun@bjtth.org), Beijing Tiantan Hospital, Capital Medical University, No. 119, S 4th Ring W Rd, Fengtai District, Beijing 100070, China.

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