Does Tenecteplase Before Thrombectomy Benefit Patients with Large-Vessel Occlusion Stroke?

Tenecteplase pretreatment improved outcomes in patients treated within 4.5 hours.

In trials involving patients with acute ischemic stroke, intravenous thrombolysis (IVT) given before endovascular thrombectomy (EVT) is a common strategy. However, most of these trials used alteplase as the thrombolytic agent, whereas many centers now use tenecteplase (NEJM JW Neurol May 22 2018 and N Engl J Med 2018; 378:1573). Might tenecteplase provide a benefit before EVT? To find out, investigators from China randomized 550 patients with acute ischemic stroke and large-vessel occlusion who could be treated within 4.5 hours after stroke onset to either tenecteplase (0.25 mg/kg) plus EVT or EVT alone. The primary outcome was functional independence at 90 days, defined as a modified Rankin Scale score of 0–2.

The results were as follows:

Pa…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Does Tenecteplase Before Thrombectomy Benefit Patients with Large-Vessel Occlusion Stroke?

Topics

Reviewing Author