Tenecteplase Without Thrombectomy in a Late Acute Stroke Time Window

Currently, the established timeframe for use of intravenous thrombolysis (IVT) for acute ischemic stroke is 4.5 hours, although select patients with “wake up” strokes can also be treated. A definitive benefit from tenecteplase administered beyond 4.5 hours has not been demonstrated thus far but would be relevant to the large portions of the world's population that do not have access to mechanical thrombectomy (MT). Investigators in China have now conducted a randomized trial of tenecteplase versus standard medical treatment in patients with an ischemic stroke in the previous 4.5 to 24 hours and with evidence of large-vessel occlusion (LVO) and a mismatch between the core infarct and hypoperfused area on perfusion imaging. Patients received …