Intra-Arterial Tenecteplase After Thrombectomy for Acute LVO Stroke: What Dose?

The jury is still out: DATE finds a safety signal with the dose that had suggested efficacy without a safety signal in ANGEL-TNK.

For patients with acute large-vessel occlusion (LVO) stroke, endovascular thrombectomy usually is successful at recanalizing the proximal target lesion. But residual occlusion of more-distal vessels or thrombosis of the microcirculation — known as the no-reflow phenomenon — can still hamper tissue reperfusion, resulting in additional infarction and worse outcomes. Intra-arterial thrombolysis may require lower doses than systemic intravenous (IV) thrombolysis. Now, the DATE investigators report results of formal dose-finding and dose-expansion studies of intra-arterial tenecteplase after thrombectomy.

Key findings:

In the dose-finding study, 48 patients with successful eTICI 2b (reperfusion of ≥50% of the territory) to 3 (complete) reperfusion…

Reviewing Author

Anthony S. Kim, MD

Disclosures

Grant/Research SupportNIH/National Institute of Neurological Disorders and Stroke; NIH/National Center for Advancing Translational Sciences

Anthony S. Kim, MD

Disclosures

Grant/Research SupportNIH/National Institute of Neurological Disorders and Stroke; NIH/National Center for Advancing Translational Sciences

Intra-Arterial Tenecteplase After Thrombectomy for Acute LVO Stroke: What Dose?

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Reviewing Author